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f UPPLEMENTS TO THE BULLETIN OF THE HISTORY

OF MEDICINE

Editor: Henry E. Sigerist
Associate Editor: Genevieve Miller

No. 3

ESSAYS

THE HISTORY OF MEDICINE

presented to

PROFESSOR ARTURO CASTIGLIONI
on the occasion of his seventieth birthday
April 10, 1944

iB'

BALTIMORE

THE JOHNS HOPKINS PRESS
1944

SUPPLEMENTS TO THE BULLETIN OF THE HISTORY
OF MEDICINE

Editor: Henry E, Sigerist
Associate Editor: Genevieve Miller

No. 3

ESSAYS

IN THE HISTORY OF MEDICINE

presented to

PROFESSOR ARTURO CASTIGLIONI
on the occasion of his seventieth birthday
April 10, 1944

BALTIMORE

THE JOHNS HOPKINS PRESS
1944

PRINTED IN THE UNITED STATES OF AMERICA
BY J. H. FURST COMPANY, BALTIMORE, MARYLAND

CONTENTS

^ , wo

PAGE

Epistola Dedicatoria: Henry E. Sigerist. 1

Vita and Bibliography of Professor Arturo Castiglioni . 8

Paul Bert’s Triumph: Erwin H. Ackerknecht . 16

Random Thoughts with a Hopeful Purpose: Alberto Ascoli . 32

La Historia de la Medicina y ef Perfeccionamiento Medico: Juan

Ramon Beltran . 43

Giovanni Maria Lancisi and “ De Subitaneis Mortibus ”: Massimo

Calabresi . 48

Sydenham and Cervantes: Ludwig Edelstein . 55

0 Museu de Psiquiatria e de Antropologia Criminal Organizado por

Cesare Lombroso: Carlo Foa . 62

Polydore Vergil, His Chapters on the History of Physick and His

Anglica Historia: John F. Fulton . 65

Jean Antoine Francois Ozanam, 1773-1837, Soldier, Physician, Epi¬
demiologist: Iago Galdston . 89

Angina Inflammatoria (Diphtheria?) As Described in David Orme’s
Edinburgh Dissertation (1749) and Benjamin Morris’ Leyden
Dissertation (1750): Edward B. Krumbhaar and W. B.

McDaniel, 2d. 103

Medicina Aborigen Peruana: Juan B. Lastres . 130

A Short Chronology of Important Events in Cardiology: Aldo A.

Luisada .'. 152

Diabetikerdiaten der Vorinsulinara: Adolf Magnus-Levy . 161

Los Hospitales de America Durante la Epoca Colonial: Carlos

Martinez Duran . 170

Mignotydea, an Undescribed Epidemiological Monograph of the Cinque-
cento: Claudius F. Mayer .

iii

184

CONTENTS

PAGE

La Historia y la Filosofia de la Ciencia: Aldo Mieli . 205

Directions for the Use of an Early American Marine Medicine Chest:

Genevieve Miller. 217

Some Relations between British and German Medicine in the Seven¬
teenth Century: Max Neuburger . 223

Medical Matters in Marco Polo’s Description of the World: Leonardo

Olschki . 237

Medidas de Seguridad contra la Fiebre Amarilla durante el Virreynato

del Peru: Carlos Enrique Paz Soldan . 260

Der Zahnbrecher des Hans Sachs: Curt Proskauer . 267

Beccaria (1738-94): George Sarton . 283

Frederic Berard, Historien de la Medecine: Raymond de Saussure 309

Le Manuscrit du Regime du Corps d’Aldebrandino, de la Biblioth^ue

d’Ajuda, a Lisbonne: Augusto da Silva Carvalho . 318

Retail Pharmacy as the Nucleus of the Pharmaceutical Industry:

George Urdang . 325

Index of Names. 347

CONTRIBUTORS

Erwin H. Ackerknecht, M. D., Fellow in the History of Medicine,
The Johns Hopkins Institute of the History of Medicine, Baltimore,
Md.

Alberto Ascoli, M. D., formerly Professor of Patholc^ and Director
of the Vaccine Institute, University of Milan; now Professor of
Bacteriology, Middlesex College of Medicine and Surgery, Waltham,
Mass.

Juan Ramon Beltran, M. D., Catedratico de Historia de la Medicina,
Facultad de Ciencias Medicas de Buenos Aires.

Massimo Calabresi, M. D., formerly Associate Professor of Clinical
Medicine, University of Milan; now Assistant Clinical Professor,
Yale University School of Medicine, New Haven, Conn.

Ludwig Edelstein, Ph. D., Associate Professor of the History of
Medicine, The Johns Hopkins Institute of the History of Medicine,
Baltimore, Md.

Carlo Foa, M. D., formerly Professor of Physiology and Director of
the Institute of Physiology, University of Milan; now Professor of
Experimental Pathology, University of Sao Paulo, Brazil.

John F. Fulton, M. D., Professor of Physiology, Yale University
School of Medicine, New Haven, Conn.

Iago Galdston, M. D., Executive Secretary, Committee on Medical
Information, New York Academy of Medicine, New York, N. Y.

Edward B. Krumbhaar, M. D., Professor of Pathology, University of
Pennsylvania School of Medicine, Philadelphia, Pa.

Juan B. Lastres, M. D., Catedratico principal titular de Semiologia y
Clinica Propedeutica en la Facultad de Ciencias Medicas de Lima,
Peru.

Aldo a. Luisada, M. D., formerly Professor of Pathology, University
of Ferrara; now Professor of Pharmacology, Middlesex College of
Medicine and Surgery, Waltham, Mass.

W, B. McDaniel, 2d, Ph. D., Librarian, College of Physicians of Phila¬
delphia, Pa.

Adolf Magnus-Levy, M. D., formerly Physician-in-Chief, Krankenhaus
Friedrichshain, Berlin, Germany.

Carlos Martinez Duran, M. D., Profesor de la Universidad de San
Carlos de Guatemala.

VI CONTRIBUTORS

Claudius F. Mayer, M. D., Editor of the Index-Catalogue of the
Library of the Surgeon General’s Office (Army Medical Library),
Washington, D. C.

Aldo Mieli, Ph. D., until recently Professor of the History and Phi¬
losophy of Science and Director of the Institute of the History and
Philosophy of Science, Universidad del Litoral, Santa Fe, Argentina.

Genevieve Miller, M. A., Assistant in the History of Medicine, The
Johns Hopkins Institute of the History of Medicine, Baltimore, Md.

Max Neuberger, M. D., formerly Professor of the History of Medicine,
University of Vienna; now associated with The Wellcome Historical
Medical Museum, London, England.

Leonardo Olschki, Ph. D., formerly Professor at the University of
Heidelberg, Germany, and at the University of Rome, Italy.

Carlos Enrique Paz Soldan, M. D., Profesor de Higiene y Director
del Institute de Medicina Social de la Universidad de Lima, Peru.

Curt Proskauer, D. D. S., formerly of Breslau, Germany.

George Sarton, D. Sc., Professor of the History of Science, Harvard
University, Cambridge, Mass.

Raymond de Saussure, M. D., Ecole Libre des Hautes Etudes, New
York, N. Y.

Henry E. Sigerist, M. D., Professor of the History of Medicine and
Director of the Johns Hopkins Institute of the History of Medicine,
Baltimore, Md.

Augusto da Silva Carvalho, M. D., Academy of Sciences, Lisbem,
Portugal.

George Urdang, Ph. D., Director of the American Institute of the
History of Pharmacy, Madison, Wis.

EPISTOLA DEDICATORIA

To Arturo Castiglioni on his Seventieth Birthday,

April 10, 1944

Dear Friend:

Every morning we go through the same agony. We open the news¬
papers and read about new destructions on Italian soil. The Abbey
of Monte Cassino is gone. I do not care whether it was Bramante who
built the courtyards or some other architect; but they were beautiful with
their noble arches reflecting the simplicity and harmonious outlook of the
Renaissance. We read that the railroad yards of Florence have been
bombed, and we tremble because we know how close to the station Santa
Maria Novella is. Bologna has been attacked, and we wonder whether
the old towers that have seen so much warfare will be strong enough to
resist this last onslaught.

We grieve not only for the great works of art that are irreparably lost,
but also for the many minor ones. In Italy, in every town, in every street,
one suddenly sees a fountain, a house, a balcony, a window corner, a flight
of stairs, or a banister, works of some unknown craftsman and yet of
such perfect beauty that you cannot forget them. I remember a door¬
knocker that we cmce saw together — I believe it was in Capodistria—
which has haunted me ever since. It was just a doorknocker, of bronze,
green with age, not made for a museum but for a'highly practical purpose,
one it is still serving today. It was a work of the Cinquecento: a young
woman, nude, with a body of perfect proportions, standing on a sea-shell
with Amoretti riding dolphins on both sides. Aphrodite Anadyomene,
I suppose, yet so human, a Zulietta rather. And every visitor who came
took her in his hand to announce his coming. What a sensuous time it
was when man felt the urge to surround himself with beauty.

How many such doorknockers are being destroyed today, and other
minor works of art that have no stars in the guide-books but have
enriched the world so tremendously, and have been a source of inspiration
and happiness for many generations.

We all suffer from the destruction that the fascist gang has brought
upon Italy, because we are well aware that we are losing much of our
common heritage; but how much harder is it on you whose fatherland
Italy is.

HENRY E. SIGERIST

It really is ironical that you, of all people, should be an exile from your
country. Born in Trieste, seventy years ago, when the city was still
Austrian, you were always an irredentista whose most ardent desire was
to see the city with its overwhelmingly Italian population become part of
Italy. The Austrian authorities well knew what they did when they kept
you in Vienna during the last war. And when in 1918 the Italian tricolor
was hoisted in Trieste, nobody could possibly rejoice more than you.

You served your country passionately as a citizen, as Chief Medical
Officer of the Lloyd Triestino and the Italian Lines, as an academic
teacher in Siena, Padua, and Perugia, as a lecturer in foreign lands, as a
writer and scholar. We used to tease and scold you for your Italianism
and used to tell you that you were biased in favor of Italy. And then all
of a sudden, in 1938, the government of the coimtry that you had served
so well repudiated you.

I well remember the day when the new laws were passed. It was in
the fall of 1938 while the Xlth International Congress of the History of
Medicine was being held in Jugoslavia. Already you had been refused a
passport. Most members of the Italian delegation were our friends, and
I remember how outraged they felt when we read the text of the new
laws in the papers. They justly pointed out that anti-semitism had never
been an issue in Italy, that racial discrimination was foreign to the very
concept of the Civis Romanus that the government had been extolling for
years. They realized that it was a surrender to nazism, that the German
once more was extending his grip threateningly over Italy.

For a man of your ardent patriotism it might have been tempting to
adhere to a regime that was glorifying the nation and wanted to restore
the Roman empire in all its grandeur and glory. Many succumbed to the
temptation, and not only fools or opportunists. You did not. You were
too much of a democrat and liberal to accept fascist tyranny. As a scientist
and historian you saw through the hollowness of fascist rhetoric and
knew only too well that the regime was leading the country, your beloved
country, into a catastrophe. And so the day came when you had to take
the bitter road into exile.

America gave you a friendly reception. You had been in this country
before. In 1933 you had given the Noguchi Lectures at The Johns
Hopkins University, had lectured in other universities and before medical
societies. You had made many friends. Yale University gave you an
opportunity to continue your research and teaching and you, a Renaissance
scholar, could not have had a better place in which to work than in the
midst of the unique collection of our great medical humanist, Harvey
Cushing.

EPISTOLA DEDICATORIA

Life in exile, however, even under the best conditions, is always a hard
lot, and only those can fully realize the extent of your sacrifices who had
known you in Italy, in Trieste, the city in which you were deeply rooted,
where you had your family and so many friends; those who had seen you
in your beautiful home, in your study with its Renaissance furniture
where you worked surrounded by paintings of old masters, by old books
every one of which was a friend, by pharmacy jars that you had collected
during a lifetime; or those, finally, who had seen you on the lecture
platform at the University of Padua keeping an audience of young men—
and women—spellbound.

Only few realize what it means for a writer and teacher to be obliged
to change languages, particularly at an advanced age, and particularly
when it is the change frcwn a Romance language to English. The language
in which we uttered our first words, in which we expressed our emotions,
in which we formulated our thoughts and developed our own style has
become an essential part of our personality. Only those who have gone
through the experience know that feeling of humiliating helplessness and
frustration that a mature scholar feels when all of a sudden he has to
carry on his work in a foreign tongue and know how much time it takes
before he is able to express himself in his own personal style in the new
language.

You had been a writer all your life. As a young medical student in
Vienna you already were correspondent of two Italian newspapers. After
the liberation of Trieste you were editor of a daily newspaper for a year.
And while you were contributing 164 scholarly books and papers, you
continued your journalistic activities. But you were not only a writer,
you were an orator also. You mastered to a high degree that great art
that has flourished on Italian soil from the days of Cicero. More than
once I watched you addressing an audience, developing your thought in
well balanced periods, picturing a situation in colorful images, working
up your audience in a breath-taking crescendo until it was carried away
with enthusiasm—and your collar was soaked with sweat. The first time
I heard you give a lecture in English I almost wept. You were like an
eagle whose wings had been clipped.

The period of adjustment was not an easy one, and we who have been
close to you all these years are filled with admiration for the courage with
which you made a fresh start. Many other refugees became bitter,
disgruntled, critical of their new environment and sometimes even arro¬
gant. They forgot the dangers from which they had escaped and
remembered only the life they had been leading at home before they had

HENRY £. SIGERIST

been threatened in their security. You kept your sense of humor and your
esprit de galanterie, and when we heard you make jdces in English with
the same ease with which you used to make them in Italian, French,
German or Spanish; when we heard you pay compliments to the ladies,
we knew that you had begun to feel at home in the new world.

We also greatly admire Mme. Castiglioni, your wife, for whom the
adjustment to the new environment was infinitely more difficult. We,
after all, have our books and when we have boc^s we can do our work
wherever we happen to be. A wife misses her relatives, her friends, the
comforts of her former home, the infinity of little things that make life
pleasant, much more than we, and there is much greater heroism in her
unspectacular adjustment. You have the good fortune of having your
son with you but Laura, your daughter, is still in Europe, in the midst of
the turmoil, and I know what a source of worry this is for you both.

Italy has a great tradition in medical historiography. A country which
for many centuries contributed so much to the advancement of medicine—
how much has Padua alone given to the world!—could not but produce
great historians of medicine. In the 19th century De Renzi, Puccinotti,
Corradi, to mention only a few, laid the foundation upon which the
following century could build. The Societa Italiana di Storia Critica
delle Scienze Mediche e Naturali founded in 1907, of which you were
vice-president for ten years, became a focus of activities. Together with
such men as Carbonelli, Giordano, Corsini you developed a new Italian
school of medical history. Padua under your leadership became an active
center of studies in the field.

You had the great advantage over your colleagues that you mastered
the German language and that the rich German medico-historical literature
was therefore fully available to you. During the war you were in close
touch with Max Neuburger who was instnimental in steering you into
the field. I know that you are proud of calling yourself a discipk of
Neuburger, but I also know that he is proud of having had you as a
postgraduate student.

Your researches covered a wide range of subjects. They obviously
centered on Italy. The historian who lives in a coimtry that is packed
full of significant historical documents, many of which have never been
touched, needs not go abroad for inspiration and topics. But you entered
the general field of medical history in your studies on magic, on the
history of hygiene, of tuberculosis and of the Renaissance. Your History
of Medicine had three editions in Italy, was published in French, Spanish
and English editions, and a German translation was made long ago aind

EPISTOLA DEDICATORIA

will undoubtedly be published as soon as Hitlerism is buried. This is not
the place to enumerate your many contributions. The bibliography of your
writings included in this volume gives a vivid picture of the ground that
you have covered.

The government that persecuted you has already collapsed. The Sawdust
Caesar has already been punctured and nothing is left of him but an empty
shell. The bandits that brought misery to your country and to the world
are liquidating each other in true gangster fashion. But you are alive,
respected and honored, a representative of the eternal Italy.

Since you are an expert in magic you probably know better than I why
the seventieth birthday should be an occasion for particular rejoicing.
Some people are old and have completed their work at fifty; others are
young and still creative at eighty. But since we have the decimal system
and seven is the number of the planets, your birthday gives us a welcome
opportunity to document our friendship and to pay you tribute.

In order to give their wishes a tangible expression some of your friends
have joined in preparing this volume. Conceived in a time of war, with
a shortage of paper and difficult printing conditions, the original plan was
a very modest one, namely to dedicate to you the April number of the
Bulletin of the History of Medicine. But you have so many friends who
were eager to contribute their share, that the number grew and grew and
finally became a Supplement to the Bulletin.

Here it is. Please, accept it as a testimony of our devotion and affection.
The fact that the essays are written in six different languages shows how
widespread your reputation is and tells you that you are remembered
today in many countries; in Italy also, where you left many friends whose
voices cannot be heard yet but who, I am sure, are thinking of you today.

It is spring and Easter. How often have I been in your country at this
time of the year. There is a fragrance of mimosa and carnations in the
air. The camellias are in full bloom. The people are in the piazza chat¬
tering gaily, dressed in their new spring clothes. And suddenly from one
comer of the country to the other you hear the church bells, ringing in
joyful melodies.

Poor Italy! Beaten, starved, robbed of its sons and of its riches by a
ruthless gang, crushed under the German heel:

O patria mia, vedo le mura e gli archi
E le colonne e i simulacri e Terme
Torri degli avi nostri,

Ma la gloria non vedo.

HENRY E. SIGERIST

Non vedo il lauro e il ferro ond’eran carchi
I nostri padri antichi. Or fatta inerme,

Nuda la fronte e nudo il petto mostri.

Oime quante ferite,

Che lividor, che sangue! oh qual ti veggio,

Formosissima donna! lo chiedo al cielo
E al mondo: dite dite;

Chi la ridusse a tale ? E questo e peggio,

Che di catene ha carche ambe le braccia;

Si che sparte le chiome e senza velo
Siede in terra negletta e sconsolata,

Nascondendo la faccia
Tra le ginocchia, e piange.

Piangi, che ben hai donde, Italia mia,

Le genti a vincer nata
E nella fausta sorte e nella ria.

Let us not end on this note of sorrow. It would be foolish to assume
that Italy, that Europe at large, are finished. I believe, nay, I am certain
that there still are tremendous creative forces in Europe. The very vio¬
lence of the conflict, of the civil strife that is raging or will be raging in
every European country that is at war, makes it evident.

I know the Italian people, the peasant, the worker, the student, the
scholar. They are not the megalomaniac, aggressive crowd, roaring come
leoni, that the fascist leader wanted them to be. They are peaceful,
hardworking, decent and honest people. The fascist wave brought the
scum to the surface at a moment when the people were stunned by the
after-effects of a bloody war. If the Italians are permitted to take their
destinies into their own hands, they will not only get rid of the remnants
of fascism but also of the forces that led to it. They will create a new,
democratic Italy, with political and economic freedom for all, with more
justice and more happiness, with respect for the dignity of man.

The coming years will be hard years of struggle, of poverty and toil.
P.ut once the energies that were artificially directed toward sterile im-
tterialism, toward wanton destruction and vain boasting are freed, they
will again create timeless values as they have done in the past. Of course,
costly scientific investigations will have to be left for a while to the victor
nations, but an immortal p)oem or an immortal symphony can be written
with a pencil on a sheet of paper. Marble is plentiful in the quarries of
Carrara, and brush and paint are easy to find. The day will come when
Italy will again play its part in a liberated and united Europe.

EPISTOLA DEDICATORIA

You, my friend, and I may be too old to see this happy day, but our
children will, or their children. Today on your seventieth birthday look¬
ing back you must feel a great satisfaction in knowing that during all
these confusing years you always stood on the right side, that you
remained a humanist in the midst of barbarism, that you preferred exile
to degradation, and that you enriched the world through your work.

I present this volume to you with the most cordial wishes of all its
contributors.

Yours affectionately,

Henry E. Sigerist

The Johns Hopkins Institute of the History of Medicine
April 10, 1944.

ARTURO CASTIGLIONI

Vita

Born in Trieste, Italy, April 10, 1874,

Classic Gymnasium in Trieste, 1882-1892.

Medical School, the University of Vienna, 1892-1896; M. D. 1896.

Clinical Service at the Clinic of Prof, Schroetter, Vienna, 1896-1898.

Intern, then Resident Physician at the General Hospital in Trieste, 1898-
1904.

Head of the Sanitary Service of the Austrian Lloyd, 1899-1918; of the
Lloyd Triestino and the Italian Lines, 1918-1938.

Associate Professor (libero docente) in the History of Medicine at the
University of Siena, 1921.

Professor of the History of Medicine at the University of Padua, 1922-
1938.

Member of the High Council for Public Health, Rome, 1922-1929.

Professor of the History of Science at the University for Foreigners in
Perugia, 1924—1938.

Lecturer in the History of Medicine at the Universities of Sao Paulo,
Rio de Janeiro, Buenos Aires, and Santiago, Chile, 1930.

Hideyo Noguchi Lecturer at the Johns Hopkins University, 1933.

Lectures on medico-historical subjects at universities and medical asso¬
ciations in New York, Philadelphia, Rochester, Minn., Omaha,
St, Paul, Chicago, Yale, Rochester, N. Y., Iowa, 1933.

I.ecturer at the Royal Society of Medicine in London, 1934.

In America, November 5, 1939.

Research Associate and Lecturer in the History of Medicine, Yale Uni¬
versity, 1939; Professor, 1943.

President of the New York Society for Medical History, 1942.

Honorary Member of the Royal Society of Medicine (London), of the
Academia Nacional de Medicina (Buenos Aires), of the Gesellschaft
der Aerzte (Vienna), of the American Association of the History of
Medicine, of the Colegio de los Doctores (Madrid).

Honorary Professor of the University of Santiago (Chile).

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

Member and Italian Delegate to the Council of the Association Inter¬
nationale d’Histoire de la Medecine, Delegate of the Italian Uni¬
versities at the Tercentenary of Harvey (1929), Vice-President of
the Societa Italiana di Storia della Medicina (1929—1938), Vice-
President of the Minerva Society, Trieste. Member of the Societe
Internationale d’Histoire des Sciences, of the History of Science
Society, of the Societe Franqaise d’Histoire de la Medecine, of the
R. Academies in Turin, Genoa, of the R. Accademia dei Fisiocritici
in Siena, of the R. Istituto di Scienze e Lettere in Venice, of the
Associazione Medica Triestina. [The membership of all Italian
Societies was cancelled by Fascism in 1938.]

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

Note: The works on medical subjects are signed the ones on art, travels or
literature

A. Books and Papers on Medical, Medico-historical and Historical Subjects.

**1. Das modeme Spanien. Netie deutsche Rundschau, Berlin, 1898, vol. II,

pp. 976-987.

*2. I tumori tubercolari del laringe. Boll. ass. med. triestina, 1899.

*3. I dispensari antitubercolari. Giorn. veneto scienze mediche, Venice, Oct.

1905.

**4. La responsabilita del medico di fronte alia legge. Rivista sanitaria, Trieste,

1914.

*♦5. Un pittore e miniaturista triestino nel 1700. Valabarda, rassegna di Trieste,

Sept. 1, 1919.

6. La vita e Vopera di Santorio Santorio Capodistriano. Bologna, Licinio

Cappelli, 1920.

7. Un medico raguseo del secolo XVII. Riv. ital. di storia delle scienze

mediche, Feb., 1921, vol. XII, no. 1-2.

8. Ugo Benzi da Siena ed il “ Trattato utilissimo circa la conservazione della

sanitade.” Ibid., May-August, 1921, vol. XII, no. 5-8.

9. II trattato dell’ottica di Lorenzo Ghiberti. Ibid., May-August, 1921, vol.

XII, no. 5-8.

10. Bagni ed idroterapia nella legislazione biblica e postbiblica. Vidrologia e

terapia fisica, Florence, April, 1921, no. 4.

11. Precursor! ed iniziatori della vaccinazione a Trieste. Rivista sanitaria,

Trieste, 1921, no. 14.

12. Un lazzaretto triestino nel Settecento. Archeografo triestino, 1922, ser. Ill,

vol. 9.

13. Medici e medicine a Trieste al principio deWOttocento. Trieste, G. Balestra,

1922.

14. La medicina ai tempi e nell’opera di Dante. Architno di storia della scienza,

1922, vol. 10, no. 3-4.

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

15. Le malattie ed i medici di Benvenuto Cellini. Boll, dell’1st. Stor. Italiano

dell’arte sanitaria, 1922, vol. II, no. 11-12; also Aesculape, 1926, vol.
XVI, no. 10.

16. La farmacia italiana del ’400 nella storia dell’arte ceramica. Faensa,

BoUettino del Museo, 1922.

*17. I problemi sanitari d’Oriente in rapporto ai traffici internazionali. Atli del
I. Congr. Italo-Orientale, Trieste, 1922.

18. Antonio Maria Valsalva. Medical life. New York, Sept., 1923.

19. Gli albori del giomalismo medico italiano. Archeografo triestino, 1923,

ser. II, vol. X.

20. II concetto del contagio e della difesa sanitaria attraverso i secoli. Con-

fereme e prolusioni, 1923, vol. XVI, no. 11.

21. II libro della pestilenea di Giovanni de Albertis da Capodistria. Bologna,

L. Cappelli, 1924.

22. II salasso nell’arma gentilizia dei Manfredi, Signori di Faenza. In: Essays

on the History of Medicine, edited by Charles Singer, Zurich, 1924.

*23. La stato sanitario d’ltalia in rapporto all’economia nazionale. Economic,
1924, vol. II, no. 7-8.

*24. Public health in Italy. British medical journal. May, 1925.

25. II pensiero medico nella sua evoluzione storica. Riv. ital. di storia delle

scienze mediche, 1925, vol. XVI, no. 5-6.

26. II volto d’Ippocrate, Istorie di medici e medicine di altri tempi. Milan, Soc.

Editrice “ Unitas,” 1925.

27. II pensiero di Ippocrate. Atti del III. Congr. Naz. della Societd Italiana di

Storia della Medicina, Siena, 1926.

28. Storia dell’igiene. In: Trattato italiano d’lgiene, Torino, Unione Tipo-

grafica Editrice, 1926.

29. La forza sanatrice della natura. Rass. din. scient., 1927, vol. V, no. 1.

30. La rinascita italiana della chirurgia. Ibid., 1927, vol. V, no. 2.

31. Gerolamo Fracastoro e il suo poema. Ibid., 1927, vol. V, no. 4.

32. Lo studio di Padova nel Rinascimento. II medico italiano, 1927, no. 5.

33. A forza curativa de natureza. Gazeta dos clinicas e dos hospitaes, Sao

Paulo, March, 1927. (Cf. above no. 29)

34. II concetto della contagposita della tisi e la legislazione antitubercolare

italiana nel Settecento. Rass. din. scient., 1927, vol. V, no. 7.

35. Storia della medicina. Soc. Ed. “ Unitas,” 1927 ; 2nd ed., “ Minerva

medica,” 1933; new edition revised, A. Mondadori, 1936.

36. Un pediatra italiano nel Rinascimento. Rass. din. scient., 1927, vol. V,

no. 6.

37. I precursor! italiani di Filippo Pinel. Ibid., 1927, vol. V, no. 8.

38. II Sesto Congresso Internazionale di storia della medicina. Riv. ital. di

storia delle scienze mediche, 1927, vol. XVIII, no. 9-10.

39. Le origin! del microscopio. Discorso tenuto all’inaugurazione della Mostra

Ottica di Padova il 5 giugno, 1927. Atti del Congresso, Padua, 1927.

40. Bernardo Ramazzini a Padova. Discorso tenuto il 26 ottobre 1927 al Con-

gresso di medicina del lavoro in Carpi. Gazzetta degli ospedali e delle
cliniche, Milan, 1927, no. 45.

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

41. L’ostetricia italiana nel Rinascimento. Rass. din. scient., 1928, vol. VI,

no. 5.

42. L’opoterapia attraverso i secoli. Ibid., 1928, vol. VI, no. 8.

43. Marcello Malpighi (1628-1929). Ibid., 1928, vol. VI, no. 10.

44. Die italienischen Lehrer und Aerzte an der Wiener Medizinischen Schule.

Festschrift fiir Max Neuburger, Wien, 1928.

*♦45. II problema della Palestina. Rivista d’ltalia, IS Nov., 1928.

46. La letteratura medica italiana nel Novecento. Guida bibliografica, Milan,

1929.

47. Giovanni Martinotti, Necrologia. Boll, dell’ 1st. Star, dell’ Arte Sanitaria,

Rome, 1929, vol. VI, no. 12.

48. Giovanni Brambilla e i medici italiani alia scuola di Vienna. Rass. din.

scient., 1929, vol. VII, no. 2.

49. Domenico Barduzzi, Necrologia. Minerva medica, 1929, no. 16.

50. Lazzaro Spallanzani. Ibid., 1929, no. 17.

51. II pensiero biologico nel Rinascimento italiano. Atti della Soc. Italiana per

il progresso delle science, Riunione di Firenze, 1929, Pavia, 1930.

52. The Italian apothecary of the Renaissance. In: The Chemist and Druggist,

Special Issue, London, 1929.

53. Les etudiants flammands a Padoue. Actes du Congrks International d’His-

toire de la Medecine d’Amsterdam, 1927, Anvers, 1929.

54. Boerhaave en Italie. Ibid., Anvers, 1929.

55. Le piu antiche stampe anatomiche. Riv. din. scient., 1929, vol. VII, no. 6.

56. L’esposizione fiorentina di storia della scienza. Minerva medica, 1929,

no. 30.

57. L’opera di G. Tommasini. Giornale di clinica medica, Parma, March, 1929.

58. II magistero di Ippocrate. Conferense cliniche e di scienze mediche tenute

nella Scuola di applicazione di saniti militare, Florence, 1929, vol. IV,
pt. II.

59. Cenni storici sullo sviluppo delle concezioni di etiologia patologica e terapia

del cancro. Rass. din. scient., 1929, vol. VII, no. 11.

*60. Di un idealismo positivista. Riv. internaz. di filosofia “Logos,” 1929, vol.
XII, no. 3.

61. Le cure magiche. Minerva medica, 1930, no. 20.

62. II viaggio di un medico tedesco in Italia nel 1700. Rass. din. scient., 1930,

vol. VIII, no. 8.

63. La scuola medica padovana attraverso i secoli. Annali Merk, 1930, vol. I.

64. II contribute degli italiani alia hsiologia ed alia patologia del cuore. Nuova

antologia, 1930, no. 11; Minerva medica, 1931, no. 6.

65. Medical thought in its historical evolution. Medical life, June, 1930.

66. Jacopo Berengario da Carpi. Rass. din. scient., 1930, vol. VIII, no. 11.
**67. Impressioni di Palestina. Realtd, Sept., 1930.

68. Nel IV. centenario del poema “ Syphilis ” di G. Fracastoro. Minerva

medica, 1930, no. 39.

69. Leopoldo Marcantonio Caldani. Archivio Merk, 1930, vol. 2.

70. II Rinascimento scientifico nella storia della civilta europea. Discorso al

Congr. Internaz. di storia della medicina, Roma, 1930. Minerva medica,

1930, no. 47; Atti del Congresso, Pisa, 1931.

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

71. Famuchi e farmacie nelle piii antiche rafiigurazioni. Communicazioni KnoU,

1930, no. 10.

72. Una pagina nella storia della terapia. Ross, din. scient., 1931, vol. IX,

no. 3.

73. La scuola anatomica padovana. Annali Merk, 1931, no. 7.

74. Histoire de la medecine. Trans, by J. Bertrand and Prof. F. Gidon, Paris,

Payot, 1931.

75. Storia della tubercolosi. In: Trattato italiano della tubercolosi di L. Devoto.

Milan, Vallardi, 1931, vol. I.

76. II pensiero di G. B. Morgagni. Minerva medica, 1931, no. 21.

77. Giacomo Tommasini e la nuova dottrina medica italiana. Rass. din. sdent.,

1931, vol. IX, no. 7.

78. Impression! di un viaggio nell’America Latina. Minerva medica, 1932,

no. 6.

79. The life and work of Santorio Santorio (1561-1636). Trans, by Emile

Recht. New York, Medical Life Press, 1932. (Cf. above no. 9)

80. Italian medicine. New York, Hoeber, 1932 (Clio Medica Series).

81. Volfango Goethe biologo. Realtd, Milan, May, 1932.

82. L’orientamento neoippocratico del pensiero medico contemporaneo. Minerva

medica, 1932, no. 18.

83. Le piante magiche: 1. La mandragora. La med. internets., Milan, 1932,

no. 6.

84. Pagine di storia della medicina contemporanea. Retss. din. scient., 1932,

vol. X, no. 7.

85. Una viagem ao Brasil. Resenha din. scient., Sao Paolo, June, 1932.

**86. L’India che io ho veduto. Qttaderni del Rotary, Milan, 1932.

87. II pensiero Neoippocratico. “ Minerva Medica,” Torino, 1932.

88. Roma e il pensiero latino nella storia della medicina. Conferensa alia

Scuola di applicazione di sanitd militare, Florence, 1932, Siena, 1932.

89. Le piante magiche: 2. La ruta. La med. intemaz., Milan, 1932, no. 12.

90. Augusto Murri, Necrologia. Illustrazione Italiana, 1932, no. 52.

91. La medicina Ayurvedica. Coinunic. Knoll, 1933, vol. II, no. 2.

92. Le piante magiche: 3. II vischio. La med. internaz., Milan, 1933, no. 1.

93. Le piante magiche: 4. L’elleboro. Ibid., 1933, no. 3.

**94. La sagra della ruota. Trieste, April, 1933.

95. Le piante magiche: 5. L’asfodelo. La med. internaz., Milan, 1933, no. 4.

96. History of tuberculosis. New York, Froben Press, 1933. (C/. above no. 75)

97. Charles Patin (1633-1693). BuU. de I’Acad. de Med., 1933, vol. CIX,

no. 12.

98. L’orientation de la pensee medicale contemporaine. Ibid.

**99. Storia di un’idea. Realtd, July, 1933.

1(X). Un viaggpo di medici italiani a Budapest. Minerva medica, July 7, 1933.

101. Le piante magiche: 6. La verbena. La med. internaz., 1933, no. 5.

102. Un medico e umanista parigino professore nello Studio di Padova. Rass.

din. scient., 1933, vol. XI, no. 7.

103. Le piante magiche: 7. II silfio. La med. internaz., 1933, no. 6.

104. Le piante magiche: 8. La piantagine. Ibid., 1933, no. 8.

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

105. Gli student! di medicina polacchi aH’Universita di Padova. Atti del IV.

Congresso ttaxionale della Soc. Ital. di Storia della Medicina, Siena,
S. Bernardino, 1933.

106. Bernardino Ratnazzini, Nel terzo centenario della nascita. Minerva medico,

1933, no. 40.

107. L’opera di Bernardino Ramazzini. Atti della Soc. Med. Chir. di Padova,

BoUettino della Facoltd di Medicina e Chir. della R. Universitd, 1933.

108. Francesco Rabelais, le sue opere mediche e i suoi viaggi in Italia. Rass.

din. scient., 1933, vol. XI, no. 10.

♦*109. Le strade di Roma. Realtd, Oct., 1933.

110. Le piante magiche: 9. L’aglio. La med. internaz., 1933, no. 11.

111. The Renaissance of medicine in Italy. Baltimore, The Johns Hopkins Press,

1933.

112. Le piante magiche: 10. L’aquilegia. La med. internaz., 1934, no. 2.

113. Le piante magiche: 11. L’alloro. Ibid., 1934, no. 3.

114. Storia della medicina. Enciclopedia Italiana, March, 1934.

115. Incantesimo e tnagia. Milan, A. Mondadori, 1934.

116. La facolta medica di Padova. Minerva medico, 1934, no. 14.

117. The Neo-Hippocratic tendency of contemporary medical thought. Medical

life, March, 1934. (C/. above no. 87)

118. The medical school of Padua. Transactions and Studies of the College of

Physicians of Philadelphia, March, 1934.

119. La medicina Ayurvedica. Inf ormaciones medicos, M&rch, 19M. (C/. above

no. 91)

*♦121. Aspetti e problem! della civilta nord-americana. Realtd, June, 1934.

122. Panorama della medicina americana. Minerva medica, 1934, no. 46.

123. II dott. John Morgan da Philadelphia e G. B. Morgagni. Rass. din. scient.,

1934, vol. XII, no. 8.

124. Le piante magiche: 12. II rosmarino. La med. internaz., 1934, no. 11.

125. O doutor John Morgan e Jo^ Baptista Morgagni. Rezenha din. scient.,

Sao Paulo, Oct., 1934. (Cf. above no. 123)

126. G. B. Morgagni and the anatomico-pathological conception of the clinic.

Proceedings of the Royal Society of Medicine, 1934, no. 11.

127. Mose Maimonide, medico e filosofo (1135-1935). Rass. din. scient., 1935,

vol. XII, no. 4.

128. II serpente di Asclepio. L’illustrazione del medico, April, 1935.

129. L'opera di Mose Maimonide. Israel, March 28, 1935.

130. Uorto della sanitd. Bologna, Librerie Italiane Riunite, 1935.

131. Gerolamo Cardano e Andrea Vesalio. Rass. din. scient., 1935, vol. XII,

no. 12.

132. Gerolamo Segato, Commemorazione nel Teatro di Belluno. Riv. ital. di

storia delle scienze mediche, 1936, vol. 27, no. 9-10.

133. Pagine di storia del pensiero medico mediterraneo. Rass. din. scient., 1936,

vol. XIV, no. 10.

134. Pietro d’Abano. Discorso per I’inaugurazione del monumento. Minerva

medica, 1936, no. 12.

135. Giovanni Rasori, il medico del Romanticismo italiano. Rivista (TItalia,

May, 1937.

14 BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D.

136. Civitas Hippocratica. Le forse sanitarie, 1937, no. 6.

137. Venezia nella storia medica del Rinascimento. Ibid., 1937, no. 7.

138. Nicolo Leoniceno medico ed umanista e la scuola medica ferrarese del

Rinascimento. Ross. clin. sclent., 1937, vol. XV, no. 11.

139. Visita medica a Giacomo Leopardi. Letture Leopardiane del Lyceum di

Firenze, Florence, G. Sansoni, 1938; Rhnsta di psicologia, 1938, no. 24.

140. Una pagina di storia dell’insegnamento clinico — Da Padova a Leida.

Nederland. Tijdschrift voor Gcneeskunde, 1938, vol. LXXXII, no. 40.

141. La medicina romana ai tempi di Augusto. Giornale della R. Accademia di

Torino, 1938, vol. CL

*•142. Note in margine ad un viaggio in America. Realtd, April, 1938.

143. Storia della chirurgia dell’emia. Scritti di chirurgia erniaria nel cinquan-

tenario dell’operazione di Bassini, Padua, Tipografia del Seminario, 1938.

144. La chirurgia romana ai tempi dell’Impero. Scritti in onore del Prof. Mario

Donati, Milan, 1938.

145. Storia degli ospedali navali. Bollettino delVAssociazione medica triestina,

1938.

146. Geschichte der Medizin, Deutsch von Dr. G. Stiassny. Wien & Leipzig,

Weidmann, Mediz. Verlag, 1938 (Destroyed by the Nazi, 1938).

147. The School of Salerno. Bulletin of the Institute of the History of Medicine,

1938, vol. VI, no. 8.

148. The legacy of Rome in the history of medicine. Transactions and Studies

of the College of Physicians of Philadelphia, 1939, ser. IV, vol. VII,
no. 3.

149. Aulus Cornelius Celsus as a historian of medicine. Bulletin of the history

of medicine, 1940, vol. VIII, no. 7.

150. The anatomical theater. Ciba symposia, 1941, vol. Ill, no. 1.

151. Historia de la medicina, trad. esp. de E. Capdevila y Casas. Barcelona &

Buenos Aires, Salvat Editores, 1941.

152. A history of medicine, trans. and edited by E. B. Krumbhaar. New York,

A. Knopf, 1941.

153. The serpent in medicine. Ciba symposia, 1942, vol. Ill, no. 12.

154. Galileo Galilei and his influence on the evolution of medical thought. Bull.

of the history of medicine, 1942, vol. XII, no. 2.

155. Andreas Vesalius and the Fabrica (1543-1943). Journal'of the American

Medical Association, Feb. 20, 1943, vol. 121.

156. The medical history of tobacco. Ciba symposia, 1943, vol. IV, no. 11-12.

157. The evolution of medicine among the Jews. Medical leaves, Chicago, 1943.

158. Dr. Isidor Fischer. BuU. of the history of medicine, 1943, vol. XIV, no. 1.

159. Herbs and herbals. Ciba symposia, 1943, vol. V, no. 5-6.

160. Three pathfinders of science in the Renaissance. Bulletin of the Medical

Library Association, 1943, vol. XXXI, no. 3.

161. The attack of Puteus against Vesalius and the defense of Cuneus. Yale

journal of biology and medicine, 1943, vol. XVI, no. 2.

162. Max Neuburger. Medical record, 1943, vol. CLVI, no. 12.

163. Fallopius and Vesalius. In: H. Cushing’s Bio-bibliography of Andreas

VesaUus, New, York, Schuman’s, 1943.

BIBLIOGRAPHY OF ARTURO CASTIGLIONI, M. D. 15

164. The dawn of genito-urinary surgery. Journal of urology, 1943, vol. L,
no. 5.

B. Biographies.

300 biographies of physicians and scientists for the Enciclopedia ItaUana.

C. Critical Reviews.

Reviews of Italian and foreign medico-historical books from 1921 to 1938 for
the Rivista Italiana di Storia delle Scienze Mediche e Naturali, and Minerva
Medico.

D. Journalistic Activity.

1892-1897: Correspondent from Vienna of the Piccolo in Trieste, Corriere
della Sera, Milan.

1898: Correspondent from Spain for the Wage (Vienna) and Berliner

Boersen Courier (Berlin).

1897-1937: Numerous medical articles for II Secolo (Italian), La Stampa
(Turin), Giornale d’Italia (Rome), L’lUustrazione Italiana
(Milan), II Giornale delle Meraviglie (Milan), etc.

1919-1920: Editor of the daily newspaper L’Era Nuova, Trieste.

PAUL BERT’S TRIUMPH

ERWIN H. ACKERKNECHT

A splendid English translation of Paul Bert’s great classic on aviation
medicine La Pression Barometrique, Recherches de physiologie experi-
mentale has just come off the press, 65 years after the book was first
published, and 59 years after the death of the author.^ This is, as Dr.
J. F. Fulton states in his foreword, a triumph of American scholar¬
ship in wartime for which thanks are due mainly to the translators and
the publisher. But that a scientific book should be translated and re-edited
after 65 years, not for historical but for practical reasons, is a still greater
triumph for the author himself, a triumph no other 19th century physi¬
ologist has achieved so far or is likely to achieve. As there exists almost
nothing on Paul Bert in English, and little more in French, it seems
worth while to collect at least the elementary data on Paul Bert—the man,
his work and his background.*

We are by no means blind to the fact that Paul Bert’s triumph is to a
great extent due to two fundamentally extrascientific factors: first, the
necessities of this war, fought for a large part in the air; second, the sad
and costly neglect during decades of aviation physiology in general, and
of Paul Bert’s work in particular. We by no means desire to follow the
method of certain historians who make a first-rate man out of a second-
rate man, genius out of talent, just because he enjoys the doubtful privi-

* Barometric Pressure. Researches in Experimental Physiology by Paul Bert. Trans¬
lated from the French by Mary Alice and Fred A. Hitchcock. College Book Company,
Columbus, Ohio, 1943. xxxii -H 1055 pp., 89 fig. $12.00.

* In English we know only of Dr. J. F. Fulton’s short foreword to Hitchcock’s trans¬
lation and of some very pertinent remarks in Victor Robinson’s excellent series on
Aviation Medicine in Ciba Symposia, vol. 5, no. 9, Dec. 1943. Berts’ work as colonial
administrator is well described in Stephen H. Robert’s History of French Colonial Policy,
vol. II, p. 439-445, London, 1929. In French the only more extensive works on P. Bert
are E. Berillon’s L’oeuvre scientifique de Paul Bert, Paris, 1887, and Jean Ducloz’
L’enfance et la jeunesse de Paul Bert (Bull. Soc. Sc. Hist, et Nat. de PYonne, vol. 78,
pp. 5-102, 1924). A. Dastre’s article in C. Richet’s Dictionnaire de Physiologie, vol. 2,
pp. 85-90, Paris, 1897, is valuable for its extensive bibliography. M. Berthelot’s funeral
address (M. Berthelot, Science et Morale, Paris, 1897, pp. 265-276) gives few facts, but
an excellent picture of the “ climate ” of P. Bert’s politico-scientific group. Berthelot
himself was at that tinie Minister of Education and the successor of Bert in his fight for
lay education. P. Bert’s son-in-law, J. Chailley-Bert has published a little monograph:
Paul Bert au Tonkin, Paris, 1887. The rest of the material consists of the traditional
obituaries, short brochures for popular consumption or the usual notes in encyclopedias.

PAUL BERT S TRIUMPH

lege of having been “ discovered ” by them. But second-rate men often
deserve attention not only because they are as indispensable for the total
picture of a period as are the first-rate men, but also because these second-
rate men sometimes actually are of the stuff of first-rate men, and it is
rather the accident of birth, the fact that they were born too late to be
part of one creative generation and too early to be part of the next creative
generation, which condemns them to become second-rate men, “ pupils ”
instead of “ masters.” Studying Paul Bert’s life and work one cannot help
feeling that he is such a man and that this time the blind chance of history
has thrown the spotlight on a worthy subject who for a long time had
been undeservedly forgotten.

Paul Bert, born in 1833, belonged to the generation born between 1830
and 1840, a generation with its own characteristics, but a typical “ in
between ” generation, especially as regards the two fields in which Bert
was active: science and politics. The generation of “ founders,” of
“fathers,” of those who laid the foundations on which men of the 30’s
built, the generation which actually developed and gave the classic expres¬
sion to the religion of the 19th century, the religion of science,® was the
generation bom, roughly speaking, between 1815 and 1825. It was the
generation of Claude Bernard (1818) and Pasteur (1822), of Petten-
kofer (1818), of Virchow (1821) and Helmholtz (1821), of Mendel
(1822) and Huxley (1825), of Charcot (1825) and Berthelot (1827),
of Billroth (1829) and Lister (1827), in medicine and science; of Flau¬
bert (1821), Ibsen (1828), Tolstoi (1828) and the Goncourts (1822 and
1830), in literature; of Courbet (1819) in painting; of Taine (1828)
and Renan (1823), of Marx (1818) and Spencer (1820), of L. H.
Morgan (1818) and Bastian (1826), in the social sciences. Only to the
generation born in the 40’s and especially in the 50’s: P. Janet (1855),
S. Freud (1856), P. Ehrlich (1854), J. Loeb (1859), P. Duhem (1862),
H. Poincare (1854), in medicine and science; H. Bergson (1859), L.

’ This expression at first may shock the reader. But the more philosophically minded
men of this generation were not afraid to make this admissioa To give only one example:
Renan, speaking of his youth when his friendship with Marcel in Berthelot originated,
says (M. Berthelot, Science et Morale, Paris, 1897, p. 51) ; “ Deux ou trois mots que
nous echangeames discretement nous eurent bientot prouve que nous avions ce que cree
le principal lien entre les hommes, je veux dire la meme religion. Cette religion c’etait
le culte de la verite . . . Ce que nous entendions par la verity c’etait bien la science.”
This fundamental question unfortunately cannot be discussed in more detail within the
limits of this article. On this occasion I wish to express my gratitude to Dr. O. Temkin
who in numerous discussions has helped me to a greater knowledge and imderstanding of
the philosophical aspects of 19th century sciences.

ERWIN H. ACKERKNECHT

Levy-Briihl (1857), F. Boas (1858), in philosophy and anthropology;
van Gogh (1853), Hodler (1853), Seurat (1859), in painting; only to
these men was the opportunity given to make what within certain limits
amounts to a new departure.

Paul Bert’s generation, the generation of the 30’s, is represented by
such men as Haeckel (1834), Sir M. Foster (1836), Wundt (1832),
Mach (1838), J. Cohnheim (1839), Edwin Klebs (1834), v. Leyden
(1832), Naunyn (1839), Camille Flammarion (1842), in medicine and
science; Zola (1840) and T. Hardy (1840), in literature; Pissaro
(1830), Manet (1832), Degas (1834), Sisley (1839), Cezanne (1840),
in painting; Jules Ferry (1832), Sadi Carnot (1837), Leon Gambetta
(1838), in French politics. Not that this generation was lacking in bril¬
liancy. On the contrary, it was this generation which, coming to the fore
after the debacle of 1870, gave to a humiliated and beaten France one of
the most brilliant and astonishing renaissances in history. But, except
for the great impressionists, this generation was not original, it was a
generation of “ pupils.” Bert and Cohnheim were such famous “ pupils.”
The typical scientific idea of naturalism, of studying and describing men
as animals, was by no means original with Zola. ^Gambetta and Jules
Ferry built the republic in youth and vigor, but it was on the basis of the
work of men like Raspail, Littre, Ledru-Rollin, Blanqui, etc., who, even
when physically still alive, were broken by the defeat of their country and
were worn and exhausted by the chain of revolutions which culminated in
the Third Republic. The optimism of this generation was enormous and
more spontaneous than that of any one of its teachers who had gone through
frightful struggles to establish the new credo. This generation inherited,
so to say, the belief in the certainty of progressive evolution. Claude Ber¬
nard’s tragic mask is representative not only of his own ” tourment ” *
but of the suffering of a whole generation. Pasteur, Charcot, Berthelot,
Huxley, show the same scars of mental suffering on their faces. It is pos¬
sibly more than an individual contrast and more than the simple expres¬
sion of his actually very gay and frank temperament that even on official
portraits Paul Bert looks so Rabelaisian, so lusty and cocky. At any rate,
in our culture which, at least in its heroes, values more highly a tragic
and split character, this is another reason to rank him second.

There are many other reasons why Paul Bert should have been forgot¬
ten and underestimated. As a scientist Bert was, of course, the pupil of

* See Pierre Mauriac’s excellent essay “ Le tourment de Qaude Bernard ” in Pierre
Mauriac, Aux confins de la medecine. Nouvelles rencontres, Paris, 1930, pp. 161 ff.

PAUL Bert’s triumph

Claude Bernard, even “ the ” pupil, fixed as such in the memory of people
by L’Hermite’s famous picture. He was the first assistant of Bernard
when, in 1863, Bernard eventually obtained the means to have somebody
share with him the “ taniere obscure et humide ” (P. Bert) at the College
de France. To him Bernard ceded his chair at the Faculty of Science. To
him he addressed the famous invitation “ to leave his imagination outside
together with his overcoat.” Bert was among the few to ease the last hours
of the great man, abandoned as he was by his pious family. He succeeded
him as the permanent president of the Society of Biology (to be chosen
to fill this office in this very important society from among competitors
like Brown-Sequard, who only succeeded Bert, was perhaps the greatest
and most cherished honor Paul Bert ever received). He wrote the official
summary of Bernard’s work. To Bernard he dedicated his first impor¬
tant book (On Respiration, 1870). Bert, who possessed to a high degree
“la vertu de la reconnaissance ” (Berillon), far from correcting this pic¬
ture of the eternal pupil, reinforced it by the worship he rendered to his
dead master. The fact that Bert was active in politics also influenced his
scientific reputation unfavorably; this was especially true outside France
where this activity was completely misunderstood.. It is strange enough
that the ability of Bert to do two or three things well (to write Barometric
pressure as well as to introduce a new law or to pacify Indo-China in six
months) in a world where only few people are able to do one thing well,
did not increase his fame, but rather spoiled it. The very elementary fact
that Bert died relatively young, at 53, when he had by no means given
his full measure, when in politics he was perhaps only starting on truly
original work, was extremely detrimental to his being remembered.
Finally, Bert had the hard luck to make great physiological discoveries at
a moment when scientific interest centered almost entirely on surgery and
bacteriology, when Koch, Pasteur, Neisser, Eberth or W. A. Freund,
V. Bergmann, Billroth, were the heroes of the day. His later occupation
with anesthesia, hydroperoxide, disinfectants, shows a more or less uncon¬
scious, a more or less successful, tendency to adapt his work to the trend
and fashion of the period,

Paul Bert came from Burgundy as did Claude Bernard and Pasteur,
from the charming old little town of Auxerre in the Yonne Department.
His father, the son and brother of cattle merchants, was first a lawyer
himself, then a successful Bonapartist politician and civil servant. His
mother was the daughter of another civil servant of Scotch extraction.
The wealth of the family goes back to a maternal great-grandfather.
Simon Boyer, who had become rich in buying up the possessions of the

ERWIN H. ACKERKNECHT

Church during the revolution. This activity of an “ accapareur ” was per¬
fectly legal and honorable, and it was the basis of many French bourgeois
fortunes. It is typical of the bitterness of French p>olitical discussions that
Bert, in 1880, had to go to court in order to clear the memory of Simon
Boyer, and to defend himself against the slanderous accusation of being
the great-grandson of a thievish monk. From the money he was awarded
in this trial he founded a “ prize in history.” Paul Bert’s only brother
died in his youth from tuberculosis, as did bis mother whom he lost when
he was 13. While the father was a rather severe character, the mother
seems to have been tender and unusually fond of pets which filled the
whole house and early awakened the boys’ sympathy and interest in ani¬
mals. Paul Bert’s health during his youth was rather delicate. He appar¬
ently was an ambitious and very temperamental child, full of pranks. He
started the study of engineering, but his father forced him to study law
(1853-1857). After traveling and hunting in Algeria in 1857—Paul Bert
was an enthusiastic hunter—he came back to Paris and was eventually
allowed to study medicine. His first great inspiration was the compara¬
tive anatomist, Gratiolet; but he was still spending much of his time
in the gay distractions of the Quartier Latin, composing chansons, etc.
Only in 1860, at the age of 27, did he settle down to systematic work. It
would be utterly wrong to see in Paul Bert’s long and varied studies any¬
thing “ Faustian,” as Berthelot’s shifting from one science to another
undoubtedly was. Bert’s mind was early set towards science, ever since
he had played in the “menagerie” of his mother; the law episode was
imposed upon him. He studied long, in the beginning because he enjoyed
the student’s joyous life thoroughly; later, because he wanted to have the
best possible preparation as a scientist, and no financial necessity urged
him to look early for a remunerative occupation.

Once set to work, Bert progressed quickly. In 1860 he became licencie
es sciences naturelles. In his examination he stubbornly defended his
ideas concerning respiration against the examiner Claude Bernard. It is
to the credit of both men that nevertheless they could afterwards become
such close friends. In 1863 Bert graduated in medicine with a thesis on
grafting of animal tissues, for which he obtained the prize in experimental
physiology of the Academie des Sciences. After some hesitation he refused
to make a rich marriage and to go into practice, and rather decided to
continue his scientific career, and in the year of receiving his degree he
became the assistant of Claude Bernard. In 1865 he married an 18 year
old girl from Scotland, Josephine Clayton. The marriage was an
extremely happy one; the Berts had three daughters: Henrietta, Pauline,

PAUL Bert’s triumph

Leonie (for Leon Gambetta), all of whom married. In 1866 Bert became
docteur es sciences, with a thesis on the vitality of tissues, a continuation
of his studies on grafting. From 1866 to 1867 he was professor of zoology
at Bordeaux, the youngest occupant of an academic chair in France. In
1867, after the fall of Napoleon, Gambetta sent him as prefet (governor)
to Lille to organize national resistance and to purge the administration.
After Gambetta’s resignation, Bert returned to Paris and it is typical of
Bert’s character that he immediately took up teaching again in the midst
of the shooting of the Commune. From 1872 to 1885 Bert combined the
duties of a deputy and a professor of physiology. In 1875 for his work on
barometric pressure he received the grand prix biennual de I’lnstitut, one
of the highest scientific honors given before him to men like Thiers,
Wiirtz, Guizot. In 1881 he entered the Academy of Sciences. In 1881-
1882 he was minister of education in Gambetta’s short lived Grand Minis-
tere. After Gambetta’s death in 1883 he devoted himself more and more
to colonial problems and in consequence was sent in 1886 to Tonkin and
Annam as resident general. After six months of extremely successful
activity he died from dysentery at Hanoi in November, 1886.

In his short life Paul Bert produced an amount of scientific work truly
impressive by both its quantity and its quality. He left about 200 memoirs,
books, articles and other communications. Within the limits of this short
note we are, of course, able to give but the barest outline of his accomplish¬
ments. During his travels in 1857, observations of Arabs who playfully
transplanted tails in living rats first suggested to Bert his work on the
grafting of animal tissues. The results of his experiments were published
between 1863 and 1866, and had immediate repercussions in the work of
surgeons done during the following war; the pioneer character of these
studies has been gratefully acknowledged by no less a person than A.
Carrel. Bert also experimented on blood transfusion, which indeed is a
kind of grafting. Bert developed the study of grafting into a study of
general physiological problems, the influence of the milieu on the vitality
of tissues, a typically Bernardian way to see the question.

The physiology of respiration occupied Bert practically throughout his
whole scientific life. As early as 1859 he had worked on the problem of
asphyxia. The bulk of his work on respiration was published between
1864 and 1870, starting in 1864 with an inquiry on the respiration of
batrachians, and culminating in 1870 in his 580 page book: Lemons sur
la Physiologic comparee de la Respiration.

Studies on respiration and an interest in the work of Dr. Denis Jourda-
net led Bert to his studies on the influence of changes in barometric pres-

ERWIN H. ACKERKNECHT

sure on the living organism, which he published between 1870 and 1885.
and the essentials of which are incorporated in his Barometric Pressure
which appeared in 1878, the year of Bernard’s death, and which is now
translated into English. Except for the ignorant anonymous who wrote
Bert’s obituary in the Lancet and who did not know anything about Bert’s
work, there has never been the slightest doubt that Bert’s work on baro¬
metric pressure was his greatest accomplishment and his book on this sub¬
ject, his magnum opus. Bert’s contemporaries, historians, physiologists
who know their literature, even the authors of doctors’ theses, the numer¬
ous obituaries and notes in dictionaries and encyclopedias on Bert, by
authors like Dastre, Berillon, Garrison and even de Cyon,® all agree on
this point. As there seems to exist some confusion as to when Bert
actually started his work on barometric pressure, we should like to
draw the attention of the reader to the fact that already in his book On
Respiration, written in 1868 and published in 1870, Bert in the 13th chap¬
ter (p. 124) deals with this question. He outlines Jourdanet’s theory of
anoxemia in high altitudes, and not only develops a detailed plan as to
how the question must be examined experimentally (the plan he actually
follows in his book of 1878), but also reports some experiments with dogs.
It is likely that Bert was interested in the problem even before 1868, and
that for more than purely scientific reasons. In 1861, Dr. Denis Jourdanet
published the first of his six books ® on the medical implications of high
altitude climate in which he developed his theory on anoxemia, later
proved exjjerimentally by Paul Bert.^ When in the next year Napoleon

® E. de Cyon (nee Elie Zion)*wrote the article on Bert in Hirsch’s Biograph. Lexiko*
der Hervorragenden Arste oiler Zeiten und Volker, Wien, 1884, vol. 1, p. 427-28. In this
article de Cyon, a sound physiologist himself, objectively evaluates Bert’s scientific achieve¬
ments but on the other hand proffers most violent political and personal slander against
Bert, thus adequately reflecting his own curious personality. De Cyon, who in his youth
had been one of the most promising physiologists, greatly praised by Claude Bernard,
turned from Judaism and Lassalleanism to anti-Semitism and became a Czarist agent and
disreputable financial and political adventurer in Paris. There are even good reasons to
see in him the author of the notorious “ Protocols of Zioa” De Cyon hated Bert par¬
ticularly since Bert, drawing attention to de Cyon’s moral character, had made it impossi¬
ble for him to obtain a professorship in France which de Cyon coveted. It seems that
the collaborators of old Hirsch were still stranger than those of the Lancet! As Bert’s
case shows, editors indeed cannot be too careful in the choice of collaborators. There is
little doubt that de Cyon’s miserable article greatly influenced the judgment of historians
(e. g. Garrison) in regard to Bert. The facts concerning de Cyon’s mysterious life are
admirably presented in an article of Dr. Solomon R. Kagan, Medical Leaves, Chicago,
1942, vol. IV, pp. 138-145.

* Les altitudes de f Atnerique tropicale compares au niveau de la mer au point de vue
de la constitution medicate. Paris, 1861.

’ Denis Jourdanet (born in 1815) practised for many years in Me.xico and became

PAUL Bert’s triumph

III started his ill-fated Mexican adventure, which had such strange reper¬
cussions in the paintings of Manet and Henri Rousseau, Jourdanet’s
books, pointing out the unhealthiness of the Mexican climate, became a
weapon in the hands of the opposition to which Bert belonged.

Bert’s classic starts out with a historical section of 500 pages in which
he reveals himself as an accomplished historian, no less fond of historical
studies than his friend M. Berthelot. As a matter of fact, his description,
neither dry nor loquacious, is so thoroughly done that nothing more has
been added by later historians and many have drawn freely from Bert
without, however, giving him due credit. Lately somebody carried his
devotion for Bert and his “ discretion ” so far as to copy, without mention¬
ing the source, a harmless mistake in addition together with the passage
from Bert (translation, p. 196). Bert first reviews the history of moun¬
tain climbing and mountain disease from the 16th century up to 1878.
We hear about the hardships undergone by men like Bouguer, Borelli,
Spallanzani, de Saussure, in fighting the mountains, the sickness itself
and the problem it presented. A short history of balloon ascension follows.
Bert then examines the theoretical explanations of, and experiments on,
decompression, from Boyle to Jourdanet, digging up such valuable contri¬
butions as those of Cigna, Legallois, Brachet, Fernet. In spite of his feel¬
ings against the victors of 1871, he is perfectly objective towards their
work, especially that of Hoppe. Only once (p. 522) does he explode in a
well justifiable Philippic against the “ charlatanism of decimals which
leads to claim exactness for the thousandths in a number which is wrong
beyond the units,” a charlatanism which is ” common on the other side of
the Rhine.” Unfortunately Bert’s warning has hardly been heeded by
anyone and in the progress of evolution this delightful “ exactness ” has
become rather universal together with a general fetishistic devotion to
numerals. As Bert deals in his book not only with decompression but
also with high pressure, the historical part closes with a no less thorough
history of diving bells and suits, which forms an important chapter in the
history of occupational diseases, and with a history of low pressure medi¬
cal apparatus and the theories and experiments related to both phenomena.
Bert’s historical study is also sigpiificant because it proves that medical
history, written by the right man and in the right spirit, can become a

interested in the medical consequences of high altitude climate. Besides his medical books
he published the first French translation of Bernal Diaz del Castillo. He furnished Bert
with the considerable sums necessary for his experiments, and without Jourdanet, to whom
the Barometric Pressure is dedicated, Bert probably would never have been able to carry
through his research on barometric pressure.

ERWIN H. ACKERKNECHT

living and valuable tool for tackling actual medical problems, 450 pages
are filled with the record and analysis of Bert’s own 668 experiments.
Part III analyzes the findings of recent authors and brings Bert’s own
summary and conclusions.

It is obvious that a detailed analysis of Bert’s experimental work does
not lie within the limits of this article. It should be done by somebody
who is a specialist in the field of respiration physiology. Undoubtedly he
will realize that our knowledge of alveolar pressure, our technique of blood
chemistry, have improved in many details. But the writings of so versatile
an experimental genius as Bert without doubt will also suggest to him
many sound and new ideas and he will probably express astonishment at
the many unnecessary experiments that have been performed during the
last 60 years by men unfamiliar with Bert’s work, thus “ solving ” prob¬
lems Bert had solved long ago. All I wish to do here is to draw attention
to the fact that Bert did much more than clear up the riddle of mountain
sickness and the accidents of high altitude flying, as even contemporary
reports on Bert’s work are often wont to state.® His answer to this ques¬
tion is only the first of his 10 conclusions: ^

"A. The diminution of barometric pressure acts upon living beings only by lower¬
ing the oxygen tension in the air they breathe, and in the blood which
supplies their tissues (anoxemia of M. Jourdanet), and by exposing
them thus to the dangers of asphyxia” (Eng, transl., p. 1037),

But conclusion B, containing Bert’s discovery of oxygen poisoning, is
hardly of less theoretical and practical importance.

” B. The increase in barometric pressure acts only by increasing the oxygen
tension in the air and in the blootl. Up to about three atmospheres, this
increase in tension results in somewhat more active intra-organic oxi¬
dations. Beyond five atmospheres, the oxidations diminish in intensity,
probably change in character, and, when the pressure rises sufficiently,
stop completely. The result is that all living beings, air-breathing or
aquatic, animal or vegetable, complex or monocellular, that all anatomical
elements, isolated (blood corpuscles, etc.) or grouped in tissues, perish
more or less rapidly in air that is sufficiently compressed. The only

*One of the fairest judgments on Bert’s accomplishment is that of J. S. Haldane:
“ The foundations of our scientific knowledge of the physiological effects of low atmo¬
spheric pressures were laid broad and firm by the investigations of Paul Bert, which
were collected together in his book: La Pression barometrique. This book also contains
the observations of Paul Bert on the effects of high atmospheric pressures, which he was
the first to interpret clearly. Paul Bert’s conclusions remain valid up to the present day,
though they have been amplified and extended by later work ” (J. S. Haldane and J. G.
Priestley, Respiration, New Haven, 1935, p. 327).

PAUL Bert’s triumph

exception to this generalization is the spores of certain microscopic
organisms. For the higher animals, death is preceded by tonic and
clonic convulsions of extreme violence ...” (p. 1036).

Conclusion E, the general law resulting from these two far-reaching
discoveries, also should not be overlooked:

•‘E. In a general way, the benign or harmful gases (oxygen, carbonic acid, etc.)
act on living beings only according to their tension in the surrounding
atmosphere, a tension which is measured by multiplying their percentage
by the barometric pressure. The increase of one of these factors can be
compensated for by the decrease of others” (p. 1037).

Conclusion G, which explained the numerous fatal accidents of divers
and workers in diving bells and when applied in practice led to slower
decompression and the application of methods of treatment indicated by
Bert, made him the benefactor of thousands whose lives he saved, and
alone would give him a lasting place in medical history:

"G. Sudden decompression beginning with several atmospheres has an effect
only by allowing to return to the free state the nitrogen which had
become dissolved in the blood and the tissues under the influence of this
pressure” (p. 1037).

In reading Bert’s monumental book, one feels the same continuous
“ growing of respect and admiration for him ” that his faithful translators,
Dr. and Mrs. Hitchcock, experienced. And when one realizes that in
addition to a brilliant and deep intelligence an enormous amount of work
was necessary to compose this book; that this painstaking historical
research, these hundreds of experiments were performed by a man who at
the same time was a busy teacher and most actively engaged in politics,
one feels simply overwhelmed. It is true, Bert paid dearly for his labors:
his gay character changed to brusqueness, and constant overwork probably
laid the foundations for his early death.

Bert applied the results of his experiments on the tension of gases to
the field of anesthesia. In 1866 he had already elucidated another aspect
of this problem: the initial excitation. Later, between 1878 and 1885, he
was one of the first to work with mixtures of gases under pressure. His
brilliant discoveries earned for him a prize from the University of Edin¬
burgh. Though his methods are now outmoded as we have better and
cheaper apparatus, his work remains important and valuable pioneer work.

Impressive as these accomplishments are, it should not be forgotten that
Bert, under Gratiolet, started out as a comparative anatomist and zoologist
and never abandoned research in this field. In 1864 he published his

ERWIN H. ACKERKNECHT

Catalogue methodique des animaux saiwages de VYonne. He used his
years in Bordeaux for physiological and anatomical studies on fishes in
the region of Arcachon. From 1867 to the time of his death he worked
on the varied actions of the different bands of the spectrum on plants and
animals. Well known are his experiments on the chameleon. His work
on the Mimosa (published between 1867 and 1870) is part of this
research. It brought him unexpected success as governor general. When
meeting Norodon, King of Cambodia, he explained to him the mechanism
of the giant Mimosa surrounding the king’s palace. The King, in accord¬
ance with Chinese tradition, judged the statesman after his scholarship
and became his friend, therewith also changing from an enemy of France
into her friend. It is interesting that from these studies concerning the
effects of light Bert concluded the practical usefulness of exposing the
body to the sun.

That Bert was by no means infallible and sometimes made great blun¬
ders—such as opposing in 1876 Koch’s results in experiments on anthrax *
although Pasteur accepted them—need not be hidden. History proves
abundantly that this trait unfortunately is common to all men, even the
greatest.

Any evaluation of Bert which would neglect his political activities would
not only be incomplete but fundamentally false. In 1863 Bert wrote in a
letter: “ Avant d’etre naturaliste je me sens citoyen.” And even though
death robbed him of the opportunity to complete his political work and to
harvest the fruits of his political labors, it is still true that Bert was one of
the founders of the Third Republic, and accomplishments which now are
usually associated with the names of happier men who outlived him are
fundamentally his.

The combination of medico-scientific work and political activity is
much more often encountered in the history of French Republicanism than
in the history of any other country. Suffice it here to remind our reader
of the names of Bailly, Barbaroux, Brissot, Fourcroy, Guillotin, Levas-
seur, Marat, for the First French Republic; for the Second, of Blanqui,
Victor Baudin (the martyr of 1851), Buchez, Bixio, Ducoux, Littre.
Raspail, Trelat, Trousseau, Maissiat; for the Third Republic of Paul Bert,
Marcelin Berthelot, Clemenceau, Combes, Lafargue, Vaillant. I have
dealt elsewhere with the phenomenon of the “ physician-politician ” on a
general and international scale,^® and I therefore abstain here from gen-

• See F. H. Garrison, Introd. History of Medicine, Philadelphia, 1917, p. 612.

“See Ackerknecht, E. H., Sudhoffs Arch. Gesch. Med., vol. 25, pp. 71-89; sec also
R. Trisca, Les Medecins Sociologues et Hommes d'etat, Paris, 1923.

PAUL Bert’s triumph

cral discussion of the question. One of the foremost reasons for the fre¬
quency of “ scientist-politicians ” in France seems to me the fact that the
“ religion of science ” in France was supported by the masses as it was
in no other country. Moreover, Free Masonry gave to the “ religion of
science ” an organization as is not to be found elsewhere. The scientist
no longer lived in splendid isolation, nor was he only influential in a
selected circle. Rather, he had mass support; he had the possibility and,
to a certain extent, even the moral obligation to go into politics and to
put his theories into practice.

In politics Bert’s name is closely connected with the name of Leon
Gambetta, who was born later than Bert and died before him. Bert’s is
not the only scientific name connected with that of Gambetta; indeed
Charcot, whose stepdaughter married Waldeck-Rousseau, owed his chair
for nervous diseases mainly to Gambetta. Gambetta made Bert prefet,
minister, included him in the intimate circles that often met for lunch
(“les dejeuners corrupteurs ”) while Gambetta was President of the
Chamber in 1879-81,“ he called Bert’s daughter Leonie his “ filleule
laique.” Bert’s contributions to Gambetta’s newspaper La Republique
Fran(;aise, published between 1878 and 1884, fill no less than seven vol¬
umes. As Gambetta’s name seems to be connected abroad with “ fiery
radicalism,” we should like to remind the reader of the fact that in France
his group bore the less exciting title of ” opportunists,” but it is true that
Gambetta was a staunch defender of the Republic and coined the slogan
« ” Le clericalisme, voila I’ennemi.”

Bert’s main battlefield was the field of education. It is not surprising
that a university professor, if he turns to politics, should be interested in
university education—the founding of the new Universities of Lille and
Lyon is mainly Bert’s work. But his interest in education was broader
and deeper. As a champion of democracy he knew that democracy pre¬
supposes education. As a believer in science as the ultimate truth, he had
to fight for science as the basis of education. “ Les sciences peuvent seuls
enseigner la non-credulite sans enseigner le scepticisme, ce suicide de la
raison” (P, Bert). Therefore Bert relentlessly struggled for compulsory
free and lay instruction, a struggle which was won only after his death.
Therefore he fought for the admission of girls to high schools. Therefore
he sacrificed his valuable time and wrote a number of new schoolbooks
conforming to the spirit of lay education. Therefore he had to fight the
Catholic Church and its orders, especially the Jesuits, their tremendous
economic power and their interference in education.

"Joseph Reiiiach, La Vie Politique de Leon Gambetta, Paris, 1918, p. 89.

ERWIN H. ACKERKNECHT

In countries where Catholics are a minority without fixed political
tradition this struggle may easily appear quixotic or odious. But in France
and some other Latin countries it is neither; it is one of the basic features
of political life. Today when several Latin countries in Europe and else¬
where are ruled by governments sponsored by the Catholic Church and
thus clearly illustrate the political ideas of the Church where the Catholics
are the majority, this struggle has perhaps become better comprehensible
to the Anglo-Saxon observer. We devote some lines to this problem as
an understanding of it is indispensable for an understanding of Paul Bert.

The history of party life in the Third Republic only appears to be terribly
confused. Fundamentally, it seems to me, there were but two parties and
creeds: the Church and the Free Masons. Wherever the individual was
placed on the motley and ever changing map of French political parties of
the right or left, his basic loyalty belonged to one of these. This role (rf
ideological and political counterpart of the Church and protagonist of
Republicanism also explains why Free Masonry assumed its conspirative
character (e. g. although Bert certainly was a Free Mason, none of his
biographers states it expressly) and why it was bitterly persecuted in
Italy, Spain and France. It also explains phenomena so bewildering to
the foreigner as the heated discussions about the attitude taken by famous
men such as Claude Bernard in their last moments about provisions for
their burial, which both parties regarded as the supreme test of loyalty
towards one of the two “ religions.” This explains such typical facts as
the polarization of the French village around the teacher on the one hand,
the priest on the other.*^* The Catholic Church in France, which had been
the backbone of the counter-revolution (Vendee) in the 1790’s, through¬
out the 19th century continued to side with the monarchies, in which it
controlled such key positions in society as public instruction, hospitals,**
and the army. The example of Lamennais, at whose bier also a battle was ■
almost fought, had early shown how the church reacted towards attempts
to combine dissident political and social concepts with the Catholic faith.

The attitude of the Church in the Dreyfus affair in the 1890’s showed her
still uncompromising in her hatred of the Republic. If the Third Republic
wanted to live, then it had to drive the Church from all key positions. That
is why “ clericalism was the enemy.” If Paul Bert wanted to realize his

See for this whole complex Zola’s last novel La Virite (1902).

** The dangerous consequences that might result from the influence of Catholic Sisters
on hospital management became graphically clear in the bitter flght Desault had to undergo,
primarily in defense of his right of clinical teaching. See L. McAuliffe, La Rivolutum
et les Hopitaux, Paris, 1901, p. 78 f. |

PAUL Bert’s triumph

ideals he had to fight the educational aspirations of the Church and its
orders, the exemption of clerics from military service, etc. Bert did so
primarily not because he was insensitive to religious feeling. That in Indo-
China he abolished the glorious military tradition of quartering horses and
troops in temples bears witness to his respect for religion. It was a politi¬
cal fight which he undertook in France, inevitable for the republican and
believer in science.^*

Already during Bert’s lifetime a rather stupid legend was spread that
he had “ spoiled his scientific career ” in going into politics, that he had
“ abandoned science for politics,” that he “ tried to return to science ”
which in reality he had never abandoned; he was told that “ a scientist
must not mix in politics.” Bert felt deeply wounded by these assertions
“more perhaps than it suits a philosopher resigned to human jealous¬
ies.” There is a continuous tendency to “ interpret ” the life of a
scientist-politician in this way. Some years ago I dealt with similar
attempts to distort Virchow’s life history.^ While such an attitude is per¬
fectly understandable in political enemies, it is inadmissible for historians
who pretend to judge according to the evidence; it deprives its adherents
of any deeper understanding of the “ scientist-politician ” whose political
activity is not accidental, but necessarily results from fundamental beliefs
also indispensable for his scientific accomplishments. After all, neither
Paul Bert nor Virchow, nor men of later generations up to Masaryk and
Smuts, have any reason to be ashamed of their records as scientist-poli¬
ticians. The least one can say is that they have not done worse than others
and that their record does not confirm the widespread prejudice that
ignorance is the best preparation for the management of public affairs.

In Paul Bert’s case what is the evidence concerning his “ abandoning
science for politics,” etc. ? He was as genuinely a politician as he was a
naturalist. After all, he was the son of a politician and grew up in a politi¬
cal atmosphere. His law studies, afterwards so useful to him as deputy,
strengthened these tendencies. In 1863, in the midst of his first scientific
successes, he wrote the famous sentence: “ I feel that I am first a citizen
and then a naturalist.” In 1863 he published his first book: Le permis de

’* Bert himself testified to this fact by distinguishing between Catholics whose rights
and opinions he respected and the clericalism which he opposed. “ Les catholiques sont
des citoyens qui ne demandent a la societe civile que de les protegee dans le libre exercice
de leur foi. Le parti clerical demande a la societe civile a se soumettre aux dogmes du
catholicisme ” (in P. Bert, Le Clericalisme, Paris, 19(X), p. 237).

“ Berthelot, Funeral address, /. c., p. 269; Berillon, l.c., p. 107, records similar reactions
of Bert.

” Ackerknecht, /. c., p. 80 ff.

ERWIN H. ACKERKNECHT

chasse (Auxerre, 1863), and it was a f)olitical book, thoroughly liberal in
character. In Bordeaux, three years before he “ officially ” entered politi¬
cal life, he started writing popular books on science with the aim of
improving lay instruction of children and adults. In Bordeaux he lectured
before the railroad workers. That he did not do any other political work
at that time is due to the fact that there was neither the urgent need nor
the opportunity to do so. Both were given by the debacle and the revolu¬
tion of 1870. Then occurred what Berthelot related at Bert’s grave:
“ C’est sous le coup du malheur, au moment de la catastrophe et de la
mine de la patrie que nous sortimes de nos laboratoires pour apporter
notre secours a la France vaincue et demembree.”

From then on, during the last 16 years of his life, Bert was uninter-
mptedly engaged in politics. And during these very 16 years he produced
without intermption the greater and better part of his scientific work:
On barometric pressure, On anesthetics, On the effects of light and colors
on plants and animals. That is the evidence, and Dastre has characterized
the tme situation rather well when he speaks of a “ parallelism ” in Bert’s
political and scientific work. Both came from the same source and aimed
at the same goal.

Bert’s most original political achievement undoubtedly was his activity
as a colonial administrator in Indo-China. This was not a pure improvisa¬
tion. Bert was born when France, after the loss of the first, started build¬
ing a new colonial empire. He always supported the new colonial orienta¬
tion. From his extensive travels in North Africa from 1857 on, he knew
the practical aspects of colonial policy. Thus it was no wonder that Jules
Ferry, whose political interests were also divided between education and
colonial expansion, chose him as resident general for Tonkin and Annam
when Tonkin was practically unpacified and Annam in open revolt. Bert
had not only to face the opposition of the natives, but also that of the
French military authorities and bureaucrats who opposed his idea of a
protectorate and copartnership with the Indo-Chinese in the development
of the country and fostered ideas of annexation, centralization, and assimi¬
lation, ideas whose promulgation had led to the frightful situation. In
Annam, Bert came to terms with the literati-mandarins, the respected
mlers of the country. In Tonkin, on the contrary, where the literati were
hated foreigners, Bert based his rule on the popular forces which he
strengthened by social reforms and by erecting an academy to educate
his own “ literati-mandarins.” He established—a thing unheard of in the
history of colonization— a. council with elected representatives from each

Berthelot, 1. c., p. 270.

PAUL Bert’s triumph

province, most members being simple peasants. He established no fewer
than 138 schools in Tonkin. In all these revolutionary changes Bert never
neglected the respect due to the natives’ adherence to ceremonials and
native institutions, laws, etc. Even on his death bed he dreamed of giving
water-generated electricity and light to his capital Hanoi. The result of
his audacious policy which had seemed sheer madness to the “ experts ”
was that Bert left to his successor a Tonkin and Annam “ pacified and
organized as no other French colony was at that date.” ” The Australian
historian, S. H. Roberts, summarizes Bert’s work as follows:

In the few months before his death Bert had demonstrated the practicability of the
protectorate scheme and had carried out a policy which made him a tradition in
colonial annals. Indo-China in these months of 1886 shares with Madagascar
under Gallieni and Tunisia under Cambon credit of being the most successful
episode in French colonization: and Bert was directly the father of that scheme
which went through Gallieni to Lyautey and through him to the present genera¬
tion of colonial administrators. Paul Bert, in short, had an influence out of
all proportion to the changes he introduced or the actual events of his adminis¬
tration. He became a formative factor in the shaping of colonial policy and his
name a tradition,—and therein lies his real importance.^®

There is little doubt that today Paul Bert’s name and bust have been
removed from the college of the little town in Burgundy where he started
on his meteoric career, removed by those who, gambling on the defeat of
their own country, tenaciously prepared this miserable victory. But Paul
Bert’s resurrection far beyond the oceans also foretells his resurrection in
that little spot of earth in which he was rooted so deeply. And since his
resurrection will coincide with that of his unhappy and beloved country,
the man who was first a citizen and a patriot and only then a naturalist,
will regard this as his greatest triumph.

" S. H. Roberts, /, c., p. 445.
Ibid., p. 439.

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE
ALBERTO ASCOLI

1 .

In the address delivered to the 12th International Veterinary Meet¬
ing when the United States’ drive in the field of microbiology was still in
the making, I stated that only gleanings had been left for them to pick up.
Their accomplishments in infectious diseases like tularemia and brucellosis
were significant exceptions and revealed the heroism with which Ameri¬
can bacteriologists carried out their task. For almost all early investi¬
gators of the United States Public Health Service working with tularemia
contracted that disease and the cases of brucellosis among American
laboratory workers are highly sigpiificant. Welch, whom President Roose¬
velt desigpiated as America’s greatest statesman in the field of public health,
when asked his opinion concerning the really great American contribu¬
tions to medical knowledge, considered Smith and Kilborne’s fundamental
discovery (1893) of Tick Fever transmission to be a cornerstone in the
history of microbiology. It laid the basis for the findings of Ross and
Grassi, Walter Reed and his associates, Bruce, Ricketts, Kelser, and
others, on insect transmission of other protozoan and virus diseases as
well as bacterial infections.

It is disputable whether the Committee appointed by the Association of
American Bacteriologists was the proper form for launching the Manual
of Determinative Bacteriology, However, America’s minor participation
in the ascent of microbiology in the last century allowed a stricter objec¬
tivity in the coinage of a name for each microorganism. The association
of each organism with an individual, on which Bergey’s nomenclature
hinges, resulted in unforeseen difficulties. An European bacteriologist
facing contradictory versions concerning microorganisms would either
have tried to dodge them by skillful maneuvers, or endeavored to stress
the contributions of his countrymen. For example, even the choice of a
proper name for the Bacillus anthracis, although Koch’s discovery is
unanimously acknowledged, would have been at variance. In my collec¬
tion of pathogens I keep a strain of Bacillus anthracis called Davainia
which I brought from Havana, Cuba. It has been listed apart from the
other strains of anthrax bacilli because an American technician would
hardly guess that in a neighboring country a classical organism, as the
Bacillus anthracis, is called Davainia. The key to the puzzle, however,

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE

may be found in the following unprejudiced account, written by two
Americans, of the chronological developments concerning the discovery
of the anthrax bacillus, I quote from Zinsser and Bence-Jones’ Textbook
of Bacteriology, page 598: “ Especial historical interest attaches to the
anthrax bacillus in that it was the first one proved definitely to bear a
specific etiological relationship to an infectious disease. The discovery of
the anthrax bacillus, therefore, laid the cornerstone of modern bacteri¬
ology. The bacillus was first observed in the blood of infected animals by
Pollender in 1849, and, independently, by Brauell in 1857. Davaine, how¬
ever, in 1863, was the first one to produce experimental infection in ani¬
mals with blood containing the bacilli and to suggest a direct etiological
relationship between the two. Final and absolute proof of the justice of
Davaine’s contentions was not brought until the further development of
bacteriological technique, by Koch, who in 1877 isolated the bacillus upon
artificial media and reproduced the disease experimentally by inoculation
of pure cultures.” The version given by the American edition of Hutyra,
Marek, and Manninger’s textbook on Diseases of Domestic Animals is
similar.

These impartial statements thoroughly explain, and even justify the
nomenclature, Davainia, adopted by the Cuban laboratory because of its
cultural relations with Latin (French) bacteriologists.

However, if one takes as guidance the German version of this affair one
would think that such a name could be coined only by distorting the truth.
The wording used by a German textbook of Veterinary Bacteriology is
typically misleading in this matter. “ The Bacillus anthracis” says I.
Bongert in his manual ‘ Bacteriologic Diagnosis of Animal Infectious
Diseases,’ “ was discovered (entdeckt) in 1849 by Pollender in the blood
of anthrax carcasses. This finding has been confirmed by Davaine (1850)
and Brauell (1857). On the ground of careful experiments these two
investigators (Brauell 1857-58, Davaine 1863) were led to the opinion
that the rods found in the blood of anthrax carcasses were the cause of the
disease. Brauell (italics mine) and Davaine were able to prove that artifi¬
cial transmission of anthrax can be carried out solely with blood which
contains rods, not with blood free from them, as for instance blood drawn
from foetuses of an animal dead of anthrax.”

Actually the inscription on the tablet placed on Pollender’s house reads:
“ In this house Dr. Pollender discovered in 1849 anthrax bacilli.” It does
not mention, however, that Pollender’s findings were not published before
1855, at a time when the presence of “ petits corps filiformes ayant environ
le double de longueur du globule sanguin et n’offrant point de mouvements

ALBERTO ASCOLI

spontanes ” had already been noticed (by Davaine) in the blood of a sheep
inoculated with the spleen of another carcass and communicated by Rayer
(C. R. S. B. 1850, II, p. 141) to the Societe de Biologie de Paris founded
by Rayer, Davaine and others in 1848.

As to Brauell’s belief that the rods were the cause of the disease, item 22
of his second paper (Virchow’s Archiv, Vol. 14, page 463) reads as fol¬
lows: “The inoculation of anthrax blood drawn from the horse (B)
produces fatal anthrax, although the blood does not contain any rod-like
bodies; therefore these rod-like bodies are neither the contagiant matter
nor necessarily its carriers.” Surely, I would like too that a veterinarian
had played the role assigned to Brauell by Bongert. It is true that Brauel!
as head of the Department of Pathology in Dorpat carried out highly
interesting experiments on transmission of anthrax in series to domesti¬
cated animals. It also has to be admitted that his blood samples contained
anthrax bacilli since they were harmful to sheep, horses, and porcupine
and harmless to dogs and fowls. Because of improper handling, however,
contamination occurred and his rod-like bodies showed motility after three
days. The following statement by Brauell (ibidem, page 454) disapproves
Bongert: “ Finally I may be given permission to add a few remarks con¬
cerning the non-motile rod-like bodies and the motile vibrios in order to
substantiate and render complete a statement I made in the above cited
paper (Virchow’s Archiv, Vol. 11, page 142). I have maintained that the
non-motile rod-like bodies showed autonomous motility after three days. I
put forth, and purposely put forth my thought that the rod-like bodies and
the motile vibrios are one and the same structures, namely that the vibrios
are nothing else than the rod-like bodies, once they have become motile.
My recent observations did not only confirm but even heighten my belief,
inasmuch as they gave evidence of a double manner of formation of the
motile vibrios, which I shall communicate here briefly.”

Isn’t perhapsAnatole France right in saying in his La revolte desanges:
“ Quant a la sorte de verite qu’on trouve dans les livres, c’est une verite
qui fait discerner quelque fois comment les choses n.e sont pas, sans nous
faire jamais d^ouvrir comment elles sont ” ?

Anyhow it was not because of Brauell’s research work but reflecting on
the likeness of these rods to the butyric ferment described by Pasteur in
1861 that Davaine set to work and showed that the non-motile rod-shaped
bodies that he had seen in 1850 were constantly present in the spontaneous
disease and could be transmitted to rabbits by inoculation while the blood
drawn from the inoculated rabbits at a time when these rods had not yet
showed up did not transmit the disease.

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE

The importance of Davaine’s research work is stressed by Bulloch at
the very beginning of Chapter 9 on “ Cultivation of Bacteria.” “ In the
last chapter” Bulloch says, ” it was pointed out how bacteriology began
to emerge as a definite branch of science. This was the outcome of
researches, particularly of Pasteur and Davaine in France, and of Ferdi¬
nand Cohn in Germany. The prolonged researches of Davaine on anthrax
had rendered it highly probable that this disease was caused by the rod
shaped body which he had named bacteridium.” Giving the biographical
notice on Brauell, Bulloch says that Brauell ” was the first to discover
Bacillus anthracis in man (1857) but did not believe it was peculiar to
the disease.”

The praise for this achievement is bestowed on Davaine also by Kolle-
Wassermann’s “ Handbuch der pathogenen Mikroorganismen,” yet the
acknowledgment is bound by many restrictions and contentions, all of
them aimed to minimize his share in the discovery. Anyway since organ¬
isms got names of research workers who did not isolate any of them—
Klebsiellae for instance were linked with Klebs who actually failed to com¬
ply with Koch’s postulates—why should not Bacillus anthracis be given
the name of Davaine, who proved that the blood of artificially inoculated
rabbits, as long as it is free from rods, does not transmit the disease, while
it does so as soon as the rods show up in the blood stream ?

2 .

“ When contributions have been so recent,” say Castiglioni and Krumb-
haar in their History of Medicine, page 763, “ that their permanent value
is not clearly manifest, and when they are characterized especially by their
great numbers, (contemporary) authors of different countries naturally
differ more in their selections than they would for earlier periods.” In the
chapter covering the first half of the nineteenth century the credit given to
Agostino Bassi (1773-1857) of Lodi for opening new paths in micro¬
pathology is still stressed in the American edition.

I thoroughly agree with their statement that Bassi was the first to show
that the silkworm disease, mal del segno or calcino (muscardine), was
caused by a microorganism. ” The work of this distinguished man places
him,” as pointed out by Castiglioni and Krumbhaar, “ among the impor¬
tant pioneers of bacteriology. His studies on the silkworm disease lasting
from 1807 to 1835 established that it was produced by a ‘ living vegeta¬
ble cryptogamous parasite ’ and led to his generalization that many dis¬
eases of plants, animals, and man are caused by animal or vegetable para-

ALBERTO ASCOLI

sites. He found that Botrytis paradoxa was the cause of the disease and
recommended various physical and chemical methods of destroying it.
In 1846 he wrote the following significant lines: ‘ While many if not
almost all scientists^ believed and still believe that contagious materials are
of a special kind, they are actually living substances—that is to say, ani¬
mal or vegetable parasites.’ This decisive statement, based on countless
observations and long years of microscopic study, anticipated by ten years
Pasteur’s discovery of the micro-organismal causes of disease, as Marti-
notti (1894) and Grassi have observed. It was a clear vision of a great
truth which was amplified and further illuminated by the discoveries that
were to follow. According to Schoenlein’s statement, it was Bassi’s dis¬
covery that led him to search for the microscopic cause of favus—the
achorion Schoenleinii. Henle also grasped the importance of Bassi’s dis¬
covery and doubtless passed on the idea to his pupil Robert Koch.”

That Pasteur was actually acquainted with the work carried out by
Bassi is proven indirectly by his connection with the Trieste chemist Luigi
Chiozza. When Chiozza, in 1865 following the paths opened by Bassi,
succeeded in isolating the causative agent of an epidemic among the silk¬
worms of Friuli, Pasteur, at the request of Napoleon III, rushed to Villa
Vigentina, a French oasis in the center of Eastern Friuli and confirmed
Chiozza’s findings. In Pasteur’s volume “ Etudes sur la maladie des vers
a soie ” there is the following statement, which proves it directly: “ It was
known, after 1832, by the exact researches of Professor Bassi of Lodi,
that this disease (muscardine) was due to the growth in the chrysalis or
in the worm of a vegetable parasite, known as Botrytis bassiana in honor
of the man who first revealed its harmful effects.”

Bassi’s eminent place in the development of microbiology is at present
fully recognized by the historians. I quote from Bulloch’s “ The History
of Bacteriology,” page 159, “ He is justly regarded as the real founder of
the doctrine of pathogenic microorganism of vegetable origin.” Arcieri
therefore is perfectly right stating that “ Bacteriology,” (I would say
pathogenic bacteriology) “ is nothing but an integral part, the most
advanced branch of microbiology, which was founded by Bassi and not by
Pasteur, Koch or others. As a consequence, Pasteur and Koch and the
others are only followers, however glorious and pre-eminent, of Bassi.”

Yet the name of the Lodi scientist remained almost forgotten until 1922
when, on the centenary of Pasteur’s birth, it was brought to light by the
University of Pavia, where Bassi had read in 1834 the results of his
researches before a committee of members of the faculties of Medicine and
Philosophy.

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE 37

Unless the same University, where he headed the department of Internal
Medicine from 1900 to 1918 succeeds in drawing the attention of the
historians of Medicine to his achievements, oblivion threatens the memory
of the founder of the most successful weapon in our fight against pulmon¬
ary phthisis,—Carlo Forlanini. Much to my surprise, his name is entirely
omitted as such in the Encyclopedia Britannica, as also is Bassi’s in
reference to his own contribution. Although this master-work {Encyclo¬
pedia Britannica) is unquestionably a model of justice in dispensing glory
these two oversights are disturbing. Under the heading “Artificial Pneu¬
mothorax ’’ Forlanini’s name is referred to in the following manner:
“Artificial Pneumothorax, otherwise known as pneumothorax treatment
or as collapso-therapy, was first urged on theoretical grounds in 1821 by
an Irishman, James Carson of Liverpool. His views were supported by
clinical observations on spontaneous pneumothorax (Houghton 1832;
Stokes 1837) but not till 50 years later did Potain (1884) put air into a
spontaneous pneumothorax, and Caylay (1885) treat a case of haemo¬
ptysis by this method. The treatment on its modern lines may be said to
originate with Forlanini who reported his first cases in 1894.”

This account’s real significance, however, is that Forlanini in 1894
presented his first recovered cases to a meeting of the Association of
Internal Medicine, whereas actually the treatment of pulmonary tubercu¬
losis by means of an artificial pneumothorax had been devised by Forla¬
nini in 1882, two years before Potain’s and three years before Cayley’s
attempts. Castiglioni and Krumbhaar say rightly in their History of
Medicine—“It was the experimental investigations (1882) of Carlo
Forlanini (1847-1918) that led to the induction of artificial pneumothorax
in the treatment of pulmonary tuberculosis. His discussion of the improve¬
ment that follows immobility of the lung in this disease was much opposed,
but in recent years has thoroughly proved its worth.”

Under the heading “ Pulmonary Collapsotherapy ” the Italian Ency¬
clopedia Treccani deals with the matter as follows: “ Carlo Forlanini in
August 1882, a few months after Koch’s discovery of the specific agent
of tuberculosis, conceived his ingenious method and presented it in an
historical scientific paper, ‘A Contribuzione della Terapia della Tisi.’
Forlanini had been aroused by a few observations (issued in 1879 by
Brugnoli and in 1881 by Meusnier and Herard) showing the beneficial
effect produced on the evolution of the pulmonary phthisis by a sponta¬
neous hydropneumothorax. He built up the foundation of what in the

ALBERTO ASCOLI

field of pulmonary tuberculosis ought to be looked upon as a major thera¬
peutic achievement. The modest wording in his note is remarkable: “ I
am making a thrust into the field of pulmonary phthisis therapy of the
future as an explorer in unknown lands and with an unsafe base of
operations.”

The need for directions on the criteria which ought to be followed by
historians of medicine, as well as of other arts and sciences, is paramount
all over the world. The trend to stress the role played by compatriots,
because of chauvinism, has flourished under the totalitarian regimes.
For example. P. Castellino, who early recommended the use of liver in
the treatment of anemia, claimed under Mussolini’s patronage his priority,
and a committee presided over by a member of the Accademia d’ Italia
could not shun this unpleasant task. Whipple, Minot, and Murphy,
because of their logical and extensive observation and not merely a casual
approach, were rightly awarded the Nobel prize for succeeding in checking
a disease which was considered incurable.

We are inadvertently led to the concept that threads, which sometimes
are difficult to be traced and even unaccountable, may be at certain
moments mysteriously interlaced, as in a fabric, and give rise to a dis¬
covery which is looked upon as a single man’s work. It is, however,
merely the masterpiece evolved from the cooperation of people working
independently in many countries and extending over a period of years and
years, sometimes centuries. Such invisible threads are likely to escape
even the historian since they require a thorough knowledge of the branch
of science concerned. Their existence might, on the other hand, be
asserted sometimes without hesitation when wishful thinking is too exclu¬
sively turned to an unilateral valorization. Maybe that Anatole France is
right saying in his Opinions de M. Jerome Coignard, ” C’est parce que
notre esprit tourne a la mythologie, veut donner un nom et une figure a
toutes les forces secretes de la nature.”

Sir Ronald Ross was given the Nobel prize in 1902 and thus rewarded
for having demonstrated that the Anopheles was the transmitter of the
malarial plasmodium. He found it in the stomach wall of infected mosqui¬
tos in 1897. It was Grassi, however, who carried out the decisive step in
1898 when he showed that malaria could be transmitted from man to man
by the genus Anopheles carrying the plasmodium in its digestive tract.

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE

In any discussion of insect transmission of protozoan diseases there are
several prominent investigators who ought to be mentioned. The way had
been paved by Manson who, as far back as 1877, had found the mosquito
to be a vector of Filaria sanguinis. As to the transmission of disease from
mammals to mammals it might be said that even Smith and Kilbome’s
findings in Texas Fever had been anticipated by Carlos J. Finlay’s divina¬
tion that Stegomya fasciata was the vector of yellow fever, a prophecy
which in 1900 was found to be true by the American expedition headed
by Walter Reed.

Visible threads can especially be traced in cases where tangible economic
factors are involved. It was not a mere coincidence that Pasteur’s first
linkage of an infection to a microscopic causative agent was achieved in a
region where the silkworm industry was of great economic importance.
Lombardy was a region having a similar industry, where Bassi accom¬
plished his remaj kable studies in the same field. Silk manufacture was at
that time the main industry of entire provinces and so it was extremely
necessary to check the diseases which were doing so much harm to this
trade. In the same way, Theobald Smith’s demonstration that Texas
Fever was transmitted by ticks, not only pointed out an entirely fantastic
means of transmitting a protozoan disease to cattle, but resulted in the
elimination of an epizootic which in the early 19C)0’s was responsible for
an annual loss of 40 million dollars to American farmers. Indeed, Ross’
discovery was fostered by England’s concern to develop her colonies.

The proper evaluation of an individual’s contribution is difficult in
work that is as interdependent as is the scientific field. An even greater
stumbling block lies in the inability of many people to discern the true
caliber of the investigators to whom each achievement is owed.

Students, for instance, as a rule put Gram almost on the same level as
Pasteur and Koch. Actually the grouping of microbes into Gram-positive
and Gram-negative ones stands forth as one of the fundamental micro¬
biological techniques, the development of which may well be considered a
major episode in the history of bacteriology. Strange as it may seem, all
know the method but few know the lifework of its discoverer. Even the
biographical notice in Bulloch’s “ History of Bacteriology ” is not pre¬
cisely correct: “Gram (Hans) Qiristian (Joachim) born 1853. Danish
physician. Born in Copenhagen. Was Director of the Medical Depart¬
ment of Frederick Hospital there. In the early eighties of last century he
worked with Friedlander in Berlin and published (1884) his famous
method of the isolated staining of bacteria.’’ This short notice is com¬
pleted by a brief account on Gram’s specific process of staining on page

ALBERTO ASCOLI

217: “What Gram found was that if bacteria are stained by Ehrlich’s
anilin-water-gentian-violet, are then treated with Lugol’s solution of
iodine in potassium iodide, and are finally placed in alcohol, the colour is
discharged from certain bacteria but is retained in other bacteria. This
Gram’s method—for Gram invented no new solution—has been modified
by many workers, but in its essence remains unaltered and is one of the
most widely practised methods of differential staining used in bacteri¬
ology.” From these notes one could even surmise that Friedlander might
have had a share in working out this procedure.

Therefore, I take this chance to reproduce here a more complete account
issued a few months after his death in Biochimica e Terapia Sperimentala
(Vol. 26, #2, page 85).

“ Christian Gram was born on September 13, 1853 and died on Novem¬
ber 14, 1938 at the age of 85, however his method was worked out when
Gram was only about 30 years old. It is not surprising that he had been
forgotten even by the Danish physicians, since he had retired so far back
as 1923 and lived henceforth in privacy avoiding publicity. His student
days at the University of Copenhagen date back to 1871. It was there,
during his early years of academic life when he devoted himself entirely
to the study of botany, that he discovered the staining method which
bears his name. And it was there, also during this same period, that he
was first appointed to the chair of pharmacology for his preparedness and
excellent knowledge in the field of medicinal plants. Actually it was in
the botany laboratory that he first became familiar with the use of the
microscope, a tool which was handled at that time by only a few research
men. Because of his proficiency in microscopical observation and technique
he was acknowledgedly superior to his environment and of this superiority
he gave a concrete proof publishing a short paper “ Ueber die isolierte
Farbung der Schizomyceten in Schnitt- und Trockenpraparaten.” This
was published in a medical journal, Fortschritte der Medisin, in 1884. It
is interesting to mention that Gram himself did not aim at a procedure for
classifying microbes within two groups, but at pointing out the deep color¬
ing of pneumococci and other cocci brought forth by his method, whereas
other organisms, such as Eberthella typhi, were entirely robbed of color
by the alcohol. Friedlander, editor of the journal and discoverer of
Klebsiella pneumoniae, immediately applied Gram’s method on a large
scale in his research work on the causative agents of pneumonia. Fried-
l^der commenting on Gram’s paper maintained the efficiency of the
method in contrast to the cautious wording at the end of Gram’s short note:
“ By my method examination of schizomycetes is carried out with far

RANDOM THOUGHTS WITH A HOPEFUL PURPOSE

greater ease and it is for this reason that I am publishing it, although I am
aware that it is very deficient and imperfect. It is hoped, however, that
as a tool in the hands of other research workers it might prove itself use¬
ful.” Because of its very simplicity this procedure has actually become a
vital part of the working knowledge of bacteriology; and that short note
has made its author more widely known than all four volumes of clinical
lectures that he published later on, during his 24 years as head of the
medical center.

The source of the above information was an obituary of Gram, brought
out by the Scandinavian Archives of Medicine. No mention was made
there of any sojourn of Gram in Berlin. Anyway the originality of Gram’s
method seems unquestionable. What, however, is open to doubt is whether
the fame of a procedure which ranks high among the fundamental bacterio-
l(^ical techniques does not implicate an overestimation of Gram’s contri¬
bution to bacteriology.

There are certainly more debatable questions in the field of the history
of Medicine. Even in an excellent monograph as the one on “Avian
Tuberculosis ” by Feldman, the report by Johne and Frothingham on
what at present is called Johne’s disease due to Mycobacterium paratuber-
culosis is still listed at page 303 with avian tubercle bacilli infections.
Twort is rightly quoted by Bulloch as the first to cultivate Johne’s bacillus
and as the original discoverer of bacteriophagic phenomena. This brings
up however the question whether the d’Herelle’s phenomena should be
rebaptized into Twort-d’Herelle phenomenon.

From the above examples is it not, perhaps, a practical suggestion that
such questions should be debated in round table discussions as the ones
included in the programs of the general meetings of the Society of Ameri¬
can Bacteriologists on “History of Bacteriology”? In the same way
questions concerning the history of immunology could be dealt with in
similar discussions by the American Association of Immunologists. Joint
sessions of affinitive societies would be best. The Associations for the
Advancement of Science would of course be the final judge to be appealed
to in controversial issues.

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D. C, 1935.

W. M. Simpson: “Tularemia.” Hoeber, New York, 1929.

I. F. Huddleson: Brucella infections in animals and man.” The Commonwealth
Fund, New York, 1935.

S. Flexner and J. Th. Flexner: “ William Henry Welch and the heroic age of
American Medicine.” The Viking Press Publishers, New York, 1941.

ALBERTO ASCOLI

Th. Smith and F. L. Kilborne: “ The nature, causation and prevention of Southern
Cattle Fever.” Rep. U. S. Department of Agriculture, Bureau of Ani ma l
Industry, Washington, D. C., 1893.

L. A. Merillat and D. M. Campbell: “Veterinary Military History of the United
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D. H. Bergey and Associates: “ Manual of determinative bacteriology.” The
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F. V. Hutyra, J. Marek and R. Manninger ; “ Diseases of domestic animals.”
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J. Bongert: “ Bakteriologische Diagnostik der Tierseuchen.” Richard Schoetz.
Berlin, 1927.

A. Pollender: “ Mikroskopische und mikrochemische Untersuchung des Milz-
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P. Rayer: “Inoculation du sang de rate.” Comptes Rendus Societe de Biologic,
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F. Brauell: “ Versuche und Untersuchungen betreffend den Milzbrand des Menschen
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F. Brauell: “ Weitere Mittheilungen uber Milzbrand und Milzbrandblut.” Ibidem

Bd. 12, 1858.

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G. Jeanson: “ Le docteur Casimir Davaine; sa vie; son oeuvre.” Paris, 1912.

W. Bulloch: “ The history of bacteriology.” Oxford University Press, London,

1938.

W. Kolle and A. v. Wassermann: “ Handbuch der pathogenen Mikroorganismen.
Milzbrand by G. Sobemheim in Vol. Ill of the 3rd edition. Gustav Fischer
and Urban & Schwarzenberg, Jena, Berlin, Wien, 1929.

A. Castiglioni and E. B. Krumbhaar: “ A history of Medicine.” Alfred A. Knopf,
New York, 1941.

R. Dollot: “ Note on Pasteur’s sojourn in Villa Vigentina.” Biochimica e Terapia
Sperimentale, Vol. 16, 1929.

G. B. Arcieri: “ Agostino Bassi in the history of medical thought.” Paper read
before the medical staff of the Parkway Hospital in New York at its meeting
on February 23, 1938. The Vigo Press, 2 Rector Street, New York City,
1938.

A. Bassi’s “ Complete works ” published by the Medico-Surgical Society. Pavia,
1925.

F. Parodi: “ La dottrina di Carlo Forlanini ” in Scritti published by A. Wasser¬
mann, Milano, 1936.

Enciclopedia italiana under the headings “ Forlanini Carlo ” and “ Collassoterapia
polmonare.” Istituti G. Treccani, 1932.

A. Ascole: “ Christian Gram e morto.” Biochimica e Terapia Sperimentale, Vol.
26, 1939.

W. H. Feldman: “ Avian tuberculosis infections.” Williams and Wilkins, Balti¬

more, 1938.

LA HISTORIA DE LA MEDICINA Y EL PERFECCIONA-
MIENTO MEDICO

JUAN RAMON BELTRAN

La historia narra la vida de la humanidad. La Medicina es el arte de
curar los dolores f'lsicos del hombre. La Historia de la Medicina es la
descripcion analitica de la lucha del hombre contra el dolor y contra la
muerte.

Si en esencia, la Historia de la Medicina es el arte de curar, tambien
es un disciplina del espiritu, una funcion social, una ciencia y una actividad
profesional. Tan complej'o contenido expresa claramente el amplio signifi-
cado de la Medicina dentro de la sabiduria Humana; y le da un lugar de
privilegio en nuestra cultura.

Todo esto refirma la necesidad de encarar los conocimientos medicos
en funcion de su proprio desarrollo para darles un sentido de cultura pro¬
fesional; y para fijar el Hmite de nuestra ciencia a la luz de la sabiduria
universal implicita a la Historia.

Hay en el saber humano un contenido, de tres aspectos diferentes e
integrates entre si. Son verdaderos sentidos de la cultura humana, puntos
cardinales de nuestra inteligencia, guias de nuestro pemsamiento. Estos
sentidos son: el de la unidad del saber, el de la forma y el de la medida.

Los conocimientos humanos son interdependientes entre si. No hay
un solo aspect© de nuestro saber, desligado de todos los demas.

La ciencia, el arte, la literatura, la historia y la filosofia estan estrecha-
niente unidas y constituyen un conj'unto inseparable al cual llamamos
cultura. La cultura es una creacion directa, una conquista del espiritu
humano. Cada progreso, cada descubrimiento, cada nueva etapa de
nuestro camino en la afanosa e infatigable busqueda de la verdad, es
consecuencia directa de la capacidad creadora, de la intuicion, la imagina-
cion o la razon.

Dentro de nuestro mundo interior, en nuestra actividad psiquica,
ninguno de sus aspectos es inseparable de los demas; lo psiquico es
ccrfiesion, convergencia solidaria y estrecha union, de nuestros senti-
niientos, inteligencia y voluntad. Y las multiples facetas de las creaciones
de nuestro espiritu a las cuales llamamos cultura, son en esencia un reflejo
de la unidad animica que las produce, y llevan tambien la esencia de esa
misma unidad.

JUAN RAMON BELTRAN

Dentro del saber se distinguen disciplinas fundamentales, y especiales.
Las primeras, disciplinas fundamentales, son implicitas a cualquier forma
de la cultura Humana; la Filosofia y la Historia pertenecen a esta clase
de disciplinas. La Filosofia es la esencia de la cultura por ser la com-
plementacion hipotetica de las verdades de la ciencia, y constituye el
fundamento doctrinario de la misma; la Historia, nos permite conocer
las etapas evolutivas de la cultura Humana refirmando su unidad en el
tiempo y en el espacio.

Las disciplinas especiales, constituyen cada una de las formas del saber
humano; la Medicina pertenece a ellas.

Hipocrates consideraba necesario trasportar la filosofia a la medicina,
y la medicina a la filosofia. “ El medico filosofo—decia—, es igual a los
dioses ”; y no encontraba diferencia entre la filosofia y la medicina, pues
“ ambas requieren desinteres, reserva, pudor, modestia en el vestido,
opinion, juicio, tranquilidad, brega, limpieza, conocimiento de lo que es
util y necesario en la vida, rechazo de la inq)ureza, y liberarse de la
supersticion.” ^

El sentido de la forma implica saber tres cosas: hablar, leer y escribir.
Pareceria pueril referirse a estas tres condiciones de la cultura cuando se
las supone en un nino egresado de las escuelas primarias; sin embargo,
no es una redundancia: es, por desgracia, una necesidad dentro de la
cultura de los medicos.

Saber hablar, no significa ser un orador o un tecnico del lenguaje. Es,
en cambio, la aptitud de poder expresar con sencillez y claridad el con-
tenido de nuestro pensamiento. Cada idea, cada juicio, implican una
elaboracion intelectual y tienen, concretamente en el lenguaje, los terminos
apropiados para comunicarlos.

Acaso es admisible en un profesional, universitario, la incapacidad de
decir sus ideas y el significado de su pensamiento? No, categoricamente
no; pero la diaria experiencia nos enfrenta con medicos incapaces de
hablar correctamente. Muchas veces he escuchado decir: para dedicarse
’ a tal especialidad de la medicina, es necesario tener facilidad de palabra.
Esta frase contiene el error de considerar a la palabra como fundamento
de una disciplina medica, y enmascara la incapacidad de pensar con ideas
distintas, unica forma de poder expresarnos con claridad.

“ Es racional pensar que, a causa del mal regimen empleado actual-

^ Hipocrates: “ De la Bienseance.” Oeuvres Computes D'Hippocrate. Traduccion de
E. Littre. T. IX, pagina 233, Paris, 1861.

HISTOBIA DE LA MEDICINA Y EL PERFECCIONAMIENTO MEDICO 45

mente, y a causa de la preferencia que se acuerda a la riqueza sobre la
virtud, no vemos mas en nuestra epoca, a Fidias en la escultura, Apeles
en la pintura e Hipocrates en la Medicina.” Esta frase de Galeno * es un
hermoso ejemplo de claridad expositiva, y puede ser aplicada con toda
justicia a la sociedad contemporanea, cuyos defectos son tan humanos
como los de todos los hombres de todos los tiempos.

La forma de expresion esclarece el concepto; por eso, Hipocrates,
Galeno, Avicena, Averroes, Claudio Bernard, entre muchos sabios ex-
tranjeros; Abel Ayerza, Luis Giiemes, Horacio Pinero, Marcial Quiroga,
entre otros de nuestros maestros, supieron ensenar con lenguaje com-
prensible, sencillo, dando a su palabra la belleza de la claridad.

Todo sabio, todo maestro, todo hombre culto, debe ser siempre artista,
por lo menos en el bien decir. Acude a mi recuerdo, en este instante, una
hermosa frase de Trousseau: “Toda ciencia, toca el arte por algunos
puntos; todo arte tiene su lado cientifico; el peor sabio es el que no es
jamas artista; el peor artista es el que no es jamas sabio.”

Ademas de esclarecer el pensamiento cientifico, la forma da poesia a la
ciencia. La ciencia es belleza, la poesia es hermosura; ambas alcanzan el
maximo de su valor, cuando se expresan con palabras y frases claramente
comprensibles. Ambas son un aspecto de la verdad metodicamente cono-
cida, de certeza constructiva y validez universal, la ciencia; de raigambre
afectiva, contenido humano y esencia emocional, la poesia. Son dos
formas, dos expresiones de la belleza puesta por Dios al alcance del
humano entendimiento.

Ill

El sentido de la medida implica la tercera dimension de la cultura. No
es una medida matematica o sensorial, ni la del contenido cuantitativo o
cualitativo de las cosas; es una capacidad autocritica y consciente, una
brujula intelectual; es una epistemologia de nuestra propia inteligencia;
y, con ella, cada hombre establece, antes de actuar, hasta donde llega su
ciencia a la luz de su conciencia.

En este caso, medida implica economia, esto es, no malgastar esfuerzo
ni capacidad, en un afan inalcanzable para nuestras posibilidades.

El sentido de la medida requiere profundidad en el pensar, claridad en
el decir, parquedad en el hablar, paciencia para escuchar, unidad en el
hacer y oportunidad para actuar.

Es indispensable pensar profunda e intensamente para no incurrir en

* Galeno: “ Que le Bon Medecin est Philosophe.” Oeuvres Medicates et Philosophiques
de Galien. Traduccion al frances por Daremberg. T. I, pagina 2, Paris, 1854.

JUAN RAMON BELTRAN

juicios erroneos por precipitaci6n o inadvertencia. Solo asi se puede llegar
a la verdad.

Es indispensable hablar claramente, para saber difundir nuestra verdad.
Y es indispensable ser parco en el hablar, para no disminuir la claridad
de nuestro pensamiento ocultandolo tras una maraha de palabras in-
necesarias. Nada tan ilustrativo sobre este aspecto del sentido de la medida
como el lenguaje de Hipocrates, cuya forma es un modelo inmortal. El
primero de sus aforismos dice: “ La vida es corta, el arte es largo, la
ocasion fugitiva, la experiencia enganosa, el juicio dificil. Es necesario
no solo hacer por si mismo lo que conviene, sino tambien hacer que el
enfermo, los asistentes y las cosas exteriores concurran.” El gran maestro
de Cos, ensena en este aforismo y en forma sobria, clara, concisa, incon-
fundible, todos los escollos de la medicina. Y las cinco frases iniciales,
encierran un mundo de sabiduria, y un infinito conocimiento de los
obstaculos contra los cuales debe luchar el medico.

Es indispensable escuchar con paciencia. Sin esta virtud, el hombre no
puede comprender el verdadero significado del pensamiento de los demas,
y esta imposibilitado para utilizarlo en su propia perfeccion; solo asi se
puede progresar.

Es indispensable la unidad en el hacer. Para ello se requiere dedicarse
a una sola cosa en cada oportunidad; no pasar a otra si antes no se termino
con la anterior; no mezclar una cosa con otra; no mezclar todo con todo,
pues eso es motive de confusion y de retardo.

La oportunidad en el actuar es un indice de sensatez y de prudencia.
Saber esperar para hacer bien las cosas, es la mas sabia ley de accion
humana.

El triunfo de un hombre no depende tanto del nivel de su cultura como
del sentido de la medida a ella implicito. Por eso, muchos superficiales,
mediocres o poco inteligentes, triunfan sobre otros mas profundos, intensos
y capaces.

La Historia de la Medicina nos ensena nuestra ciencia en funcion del
tiempo y del espacio.

Cuando analiza la evolucion del concepto cientifico al traves de los
siglos, estudia el pensamiento medico y, por lo tanto, es filosofia.

Cuando narra el lenguaje empleado por los grandes medicos para ex-
presar su pensamiento. o cuando esta escrita y dicha con galanura, es
belleza, arte, poesia.

Cuando muestra las diferentes ctapas del perfeccionamiento medico,

HISTORIA DE LA MEDICINA Y tL PERFECCIONAMIENTO MEDICO 47

y el significado de los descubrimientos, hallazgos, progresos, etc., en el
arte de curar o en la lucha contra el dolor y con la muerte, es ciencia, en
el mas estricto sentido del concepto.

Este triple aspecto, filosofico, poetico y cientifico, caracteriza la His-
toria de la Medicina. For eso, cuando el medico la estudia, aumenta su
cultura individual, deleita su espiritu y vigoriza su ciencia.

GIOVANNI MARIA LANCISI AND “DE SUBITANEIS
MORTIBUS ”

MASSIMO CALABRESI

Natura per ideas abstractas raro elucescit.

Lancisi, De subitaneis mortibus. Cap. I/I.

In the year 1705 a great number of cases of sudden death occurred in
Rome. The people were frightened. And, as it always happens in such
circumstances, the most extravagant interpretations were advanced.

Pope Clemens XI, who during his reign proved in many ways his warm
interest toward public health and welfare, directed that the causes of this
scourge should be investigated and entrusted Giovanni Maria Lancisi
with this study.

Lancisi was at that time the first physician of the pope and also pro¬
fessor of medicine at the “ Sapienza.” The choice was therefore quite
natural; but it was fortunate that a man of his qualification was available.
Lancisi was something more than a well reputed teacher and a highly
successful physician. He was a keen, original investigator, used to the
anatomic observation and to the correlation of the clinical records with
post-mortem findings. The contributions of Lancisi to medical science
are so outstanding that one feels perhaps more inclined to moderate than
to expand his admiration. His name is remembered for the description
of the striae longitudinales; he further contributed to anatomical studies
by editing the Tabulae Anatomicae of Eustachius. In the field of medical
education he is known for having established by a personal gift the
“ Biblioteca Lancisiana ” and for his discussion of the medical curriculum.
His main interest was already directed toward the diseases of the heart
and vessels, then as now the outstanding causes of sudden death; in fact
he interrupted his treatise “ De Motu Cordis et Aneurysmatibus,” pub¬
lished posthumously in 1728, to devote himself to the new problem. He
was also a distinguished epidemiologist and sanitarian, as proved by his
extensive writing on human and animal epidemics and especially by his
classic contribution “De noxiis paludum effluviae eorumque remediis.”

From such circumstances was prompted the third most famous of his
books “ De subitaneis mortibus,” published in Rome in 1707, which gives
the first modern systematic exposition of the subject.

4i * «

GIOVANNI MARIA LANCISI AND “ DE SUBITANEIS MORTIBUS ” 49

Lancisi states in the introduction that to treat intelligently of the special
problem brought forward by the Roman experience one has to study first
the causes of sudden death in general. To this subject is devoted the first
and more extensive volume of his work.

Lancisi belongs to the iatromechanical school, motivated perhaps by his
own special interest in the mechanism of the circulation. For him life
results from motion of fluids and of solids; death is the ceasing of such
motion. Therefore death should always be considered a sudden event.
However, on practical grounds, Lancisi ascribes to sudden death only
such cases “. . . quae absque ullo, vel certe breviori agone de viventium
numero tollit” (Caput IV/I).

The essential fluids are three, the air, the blood, and the nervous fluid;
and there are also three most important solids, lungs and respiratory tract,
heart and vessels, brain and nerves. The causes of sudden death are
therefore to be found in lesions of such structures and functions.

After warning that “ frequently occasions are confounded with causes
of sudden death ” (Cap. V/II), Lancisi explains that he does not separate
emotional stress from other causes of death because it acts through its
effects on the heart and the brain (Cap. V/V).

Then he proceeds to a lengthy exposition of the various mechanisms
of sudden death due to abnormal movements of the fluids and to lesions
in the structures mentioned above. Further proceeding on the solid ground
of the scientific knowledge available, our author gives a very simple and
useful clinical classification of the causes of sudden death which he groups
under three headings: suffocation, that is diseases of the respiratory
apparatus; syncope, that is cardiovascular diseases including hemorrhages;
and apoplexia, that is diseases of the nervous system. It is also possible
to divide the clinical cases of sudden attacks endangering life into two
groups “vincibiles” and “ invincibiles,” according to the issue of the
disease and the result of the treatment.

The rules for distinguishing simulated and natural apparent death from
cases of sudden death are set forth. Finally the signs from which the
physician may forecast the occurrence of sudden death are analyzed in
detail, and the rules for prevention of such accidents by healthy and sick
people are explained.

In examining the content of this volume we may say that Lancisi proves
his extensive knowledge of physiology and pathology, his ability to use
such knowledge in the interpretation of clinical facts and to make original
observation, and his unsurpassed gift for systematic exposition and orderly
classification. At the same time we find vague or confused concepts.

MASSIMO CALABRESI

chiefly in the chapters dealing with the nervous system and in the case
studies reported in the appendix, where the author elaborates extensively
upon rather meager flndings in order to give a complete interpretation of
his cases.

Lancisi is not a rebel and gives credence to the current theories when
they do not disagree with his observations; but, like his contemporary
Baglivi, he does not attach great importance to them. The reader should
not be misled by some long passages written in a style not always smooth
and terse; nor should he become discouraged if he frequently finds it
impossible to identify the descriptions given by Lancisi with our nosog-
raphy. His patience will be plentifully rewarded. As space does not
permit a detailed analysis of each chapter, I shall limit my discussion to
a few of the most remarkable passages of this work.

Acute pulmonary edema is listed among the causes of sudden death
from diseases of the respiratory system: “animals may die suddenly if
the lungs are suddenly impeded from filling with air by serum or blood
in rapid hydrops of the chest ” (Cap. IX/III^. Traumatic pneumothorax,
“by balancing the air inside and outside of the lungs” (Cap. IX/IV),
may cause sudden death. Coughing may be produced by infirmity of the
diaphragm due to lesions of the liver (XI/VI). Finally the striking
remark is uttered: “ many symptoms that appear as belonging to respira¬
tion really have their morbid origin in the heart itself and in the adjoining
vessels” (Cap. XVIII/IX).

In dealing with diseases of the central nervous system he warns that
apparently light injury of the head may cause sudden death (Cap. XI/IV).
From his observations he concurs in the opinion of others that lesions in
one hemisphere effectuate controlateral paralysis (Obsv. IVa/Scholium
XIII). Reference is made repeatedly to lesions of the blood vessels as
causes of sudden cerebral attacks. These rarely occur before 45 years of
age (Cap. XX/II). The frequent recurrence of cerebrovascular accidents
is alluded to; and a striking description of the cerebral symptoms of high
blood pressure is given: “headache, heaviness, weakness of the head,
amnesia, sleepiness, dizziness, blindness, numbness of the limbs” (Cap.
XX/II).

With regard to the diseases of the heart and vessels Lancisi gives in
part an anticipation of his more extensive work “ De Aneurysmatibus.”
We shall not examine here his fundamental contribution to the develop¬
ment of cardiolog;y. It suffices to say that he appreciates the signifi¬
cance of precordial pain (Cap. XIX/VII-VIII) and of syncope. (Cap.
XIX/IX) as forewarning symptoms; and he knows that dilation and

GIOVANNI MARIA LANCISI AND “ DE SUBITANEIS MORTIBUS ” 51

hypertrophy of the heart are underlying conditions in cases of sudden
death. He describes how intrapericardial hemorrhage causes unexpected
death (Cap. X/II and Obs. V), and is aware of the importance of hin¬
drance to diastole (Cap. X/IV). He alludes to possible abrupt changes
in blood volume (Cap. VII/I-II) and to the results of dilatation and
failure of one section of the heart (Obsv. Il/Sch. VIII). He under¬
stands the meaning of extreme bradycardia and of absolute irregularity
of the pulse (Cap. XIX/1Va. V), while palpitation unaccompanied by
other cardiac symptoms may be meaningless (Cap. XIX/VI); he
strongly denies, in contrast with Galen, any prognostic value to inter¬
missions of the pulse, and explains that this sign in healthy persons has
no significance as a symptom of heart disease (Cap. XIX/III). Most
remarkable is the observation, novel for Lancisi and the first in the
literature as far as I know, of active valvulitis (Obs. IVa/Dissectio III).
Lancisi is not satisfied with this discovery, which he compares with
chronic lesions of the valves, apparently a familiar finding to him, but
not to his contemporaries. He further explains how the soft vegetations
of the aortic valves, projecting in the lumen of the artery, may have
transitorily blocked the mouths of the coronary arteries and have caused
the syncopal attacks affecting his patient (Obs. IVa/Sch. XI). Such
unusual etiology of coronary obstruction is recognized also by modern
authors although it may be doubted whether the mechanism of the attacks
observed by Lancisi should be interpreted in this way; nevertheless we
find here stated for the first time what may be the effect of an obstacle
to the coronary circulation.

In the second volume Lancisi proposes to inquire whether the excep¬
tionally high prevalence of sudden death in Rome at that time should be
ascribed to a single agent or to a chance concentration of cases of different
origin, possibly helped by some environmental non-specific factor. Through
a stringent epidemiological and clinical analysis of his observations Lancisi
concludes for the second alternative. He could not identify any specific
agent. No single disease could show such variety of clinical symptoms
and signs and of autoptic findings as he had seen in his cases. None of
the peculiarities recognized in other epidemics could be found in the
Roman experience. There was no evidence of contagion, the incidence
was much higher among males than among females—an observation in
which any modern statistician would concur—, and finally the persons
struck by sudden death were immoderately given to the pleasures of life,
and were mostly of low social status. Reference is made to the fact that

MASSIMO CALABRESI

in spite of the high incidence of sudden death no increase in general
mortality was noticed in Rome at that time. Finally the unhealthy climate
prevailing in the year 1705 is brought into notice as a universal factor
which might have some bearing on the frightening concentration of
sudden death in that year.

The methods of treatment employed by Lancisi in his cases of impend¬
ing sudden death are detailed in the last chapter, with special emphasis
on the diet and on advice of moderation in general.

♦ ♦ ♦

For Lancisi the study of sudden death had three aspects: prognosis,
mechanism, and prevention: the same problems still confront us.

It may appear inconsistent to presume to forecast what by designation
should be unpredictable. On this Lancisi says: “ bodies subject to sudden
fate are to be considered sometimes healthy, sometimes sick.” The modem
definitions of sudden death include not only healthy individuals, but also
apparently healthy and even sick persons with no alarming symptoms.
By means of methods of physical examination unknown at his time and
of appropriate diagnostic procedures—Lancisi is senior to Auenbrugger
and Laennec and to Hales and Galvani, let alone Riva-Rocci and Einthoven
—we might be able to regard a large group of apparently healthy persons
as potential candidates for sudden death. Still, except in a few circum¬
stances, we cannot venture a precise prognosis in individual cases; and
the advice given by Lancisi of utmost caution before risking a prognosis
of impending sudden death is wisely insisted upon by the best authorities.
Furthermore the unexpected sudden collapse of a patient recently
examined with inconclusive findings, although discouraging, is not entirely
unusual.

As for the causes of sudden death we must distinguish between the
underlying disease and the ultimate functional mechanism of death;
further we should separate instantaneous death (absque ullo . . .) from
rapidly fatal disease (. . . breviori agone . . .). The anatomic classifica¬
tion of Lancisi is still generally adopted and proves useful. The emphasis
he gives to cardiovascular disease is in {jerfect ag^reement with our experi¬
ence, as obtained especially from extensive post-mortem observations of
medical examiners: Martland reports 70 % of his cases as due to cardio¬
vascular disease, as against 10% due to diseases of the central nervous
system (including cerebrovascular accidents), and 11% to diseases of
the respiratory system. Although in most cases of sudden death organic
diseases of vital organs are found post-mortem, only too frequently—

GIOVANNI MAlilA LANCISI AND “ DE SUBITANEIS MORTIDUS ” 53

especially in cases of instantaneous death—no fresh structural changes
are discovered that may be considered responsible for the death; in fact
seemingly similar lesions in other persons are not incompatible with life
and even with good functional capacity. Further the significance of some
findings, such as the so-called status thymico-lymphaticus, still is doubtful.
Therefore, in spite of our great progress in knowledge and technic, our
interpretation of the mechanism of unexpected death is still largely con¬
jectural ; and we have to resort to rather vague concepts of “ hyper-
irritable heart ” and “ hyperactive reflexes ” causing either cardiac standstill
or ventricular fibrillation.

We do not see such high incidence of sudden death as occurred in Rome
in 1705, and in other occasions in other localities also, as Lancisi reports;
yet an unusual concentration of cases among selected groups, especially
under emotional stress, is said to occur. However it may be, Lancisi
denies the predominant importance of universal factors, therefore limiting
the rules of prevention to advice of personal hygiene adapted to the
different conditions of healthy and sick persons. With these we agree,
while the active preventive treatment of sudden death is still unsatisfac¬
tory. Yet we know physical and chemical methods to stop fibrillation or
to stimulate the arrested heart; and also the preventive effects of some
drugs. We have seen that probably in some cases transitory functional
factors rather than irreparable lesions determine the sudden death. A
better understanding of such mechanisms may perhaps lead to improve¬
ment and more extensive use of the methods of resuscitation and to
effective preventive treatment; or, to follow the designations of Lancisi,
some of our cases of “ invincibilis ” sudden death may become “ vincibiles.”

The vitality of this stimulating work is proved by the fact that we may
still discuss sudden death adopting the phraseology of Lancisi. To fully
appreciate the importance of the details of this book, we should compare
the knowledge and ideas of Lancisi with those of his contemporaries,
especially with regard to diseases of the heart and vessels. Here we may
only say that Lancisi does not stand alone in the beginning of modern
studies of cardiovascular disease. However the original contributions
included in this work and in “ De Aneurysmatibus ” and the genius of
Lancisi in interpreting in terms of physiology and physics his clinical
and pathological observations are of basic significance for the development
of this field. No doubt Lancisi deserves the high place among the pioneers
of modern cardiology given to him by some historians and by most of
his followers.

MASSIMO CALABRESI

REFERENCES

Castiglioni, A.: II contribute degli italiani alia fisiologia e alia patologia del cuore.
Nuova Antologia, 1930, v. 354, p. 364.

Foote, J.: Giovanni Maria Lancisi. International Clinics, 1917, XXVII series,
V. II, p. 292.

Hoffmann, M.: Die Lehre vom plotzlichem Tod in Lancisis Werk “ De subitaneis
mortibus.” Abhandl. zur Geschichte d. Medizin u. Naturwissensch., 1935,
heft 6.

Ingleby, H.: Sudden Death. The Cyclopedia of Medicine, 1937, v. 4, p. 301.
Neuburger, M.: Die Entwicklung der Lehre von den Herzkrankheiten. Wien.

Med. Wochenschr., 1928, v. 78, p. 79a. 122.

Weiss, S.: Instantaneous “ physiologic ” death. The New England Journal of
Medicine, 1940, v. 223, p. 793.

SYDENHAM AND CERVANTES
LUDWIG EDELSTEIN

Blackmore, a physician and poet of great renown in the times of Queen
Ann and George I, but soon afterwards forgotten or belittled, in one of his
treatises poses the question whether experience or learning is more impor¬
tant for the acquisition of medical knowledge.^ His answer is that if one
must choose between the two, experience is by far to be preferred. “ For
it is very evident,” says Blackmore, “ that a Man of good Sense, Vivacity,
and Spirit, may arrive to the highest Rank of Physicians, without the
Assistance of great Erudition and the Knowledge of Books: And this
was the Case of Dr. Sydenham abovementioned, who became an able and
eminent Physician, though he never designed to take up the Profession
till the civil Wars were composed, and then being a disbanded Officer,
he entred upon it for a Maintenance, without any Learning properly pre¬
paratory for the Undertaking of it.” But while experience thus is superior
to learning, it is the possession of both these “ armours ” which in Black-
more’s opinion makes the perfect physician. Sydenham, however, Black-
more holds, took the opposite stand; he despised learning. In proof of this
thesis Blackmore continues: “And to shew the Reader what Contempt he
had for Writings in Physick, when one Day I asked him to advise me what
Books I should read to qualify me for Practice, he replied. Read Don
Quixot, it is a very good Book, I read it still. So low an Opinion had
this celebrated Man of the Learning collected out of the Authors, his
Predecessors.”

Sydenham’s bon mot on Cervantes has become very famous, and it has
usually been understood in the same way in which it was interpreted by
Blackmore. Though few go as far as he did and claim that Sydenham
vilified learning of which he was no master “ and perhaps for that rea¬
son,” * most people conclude from Sydenham’s remark that he was opposed
to book learning, his maxim being: “Read what you like; reading
books will never make a doctor ”; or that he was contemptuous at least of
contemporary learning.® Yet long ago Samuel Johnson commented on
Sydenham’s saying: “ Whatsoever was his meaning ... it is certain

’ Cf. Sir Richard Blackmore, A Treatise upon the Small Pox, 1723, pp. xi-xii.

’ Cf. Blackmore, ibid., p. xii.

’ For the former interpretation, cf. e. g. J. F. Payne, Thomas Sydenham, 1900, p. 191;
for the latter, cf. K. Faber, Nosography, 2nd ed., 1930, p. 11.

LUDWIG EDELSTEIN

that Sydenham did not think it impossible to write usefully on medicine,
because he has himself written upon it; and it is not probable that he
carried his vanity so far, as to imagine no man had ever acquired the same
qualifications besides himself.” * Moreover, Sydenham worshipped Hip¬
pocrates, the Romulus of the physicians as he calls him. He read and
reread the writings of the “ divine old man,” from which he believed the
main principles of his doctrines had been derived. He expressly acknowl¬
edged that the Hippocratic treatises and the works of other authors, small
as their number may be, contained not only the seeds of truth but truth
itself.® Nor can Sydenham have discounted the value of contemporary
erudition. He was closely attached to Locke; he was a friend of Boyle.
Both these men he praised highly in the dedications prefixed to his essays.*
Sydenham then, although he gave first place to the study of phenomena,
was in fact not a detractor of learning, nor was he an enemy of all scientific
literature.

Johnson, realizing the improbability of Blackmore’s interpretation of
Sydenham’s cryptic reply, tentatively proposed that Blackmore was misled
by “ that self-love which dazzles all mankind ” from discovering that
Sydenham perhaps merely intended to say that Blackmore would never
become a good doctor, whatever he might read.^ This explanation, how¬
ever, Johnson can give only ex eventu. Sydenham knew Blackmore appar¬
ently as a student or as a young man who had just started on his career.
It would have required the gifts of a prophet to foresee at that time the
shortcomings of the future physician, of the “ famous Modern,” at whom
Swift pokes fun in the Battle of the Books.^ Again it has been maintained
that Sydenham simply intended to ridicule Blackmore, the “ pedant
and prig.” Yet, the poetical works of Blackmore which made him the
“ butt of all the ‘ wits ’ ” were published after Sydenham’s death.® All

‘Lives of Sundry Eminent Persons [Sydenham], The Works of Samuel Johnson, XII,
1810, p. 183.

* Cf. Thomas Sydenham, Opera Omnia, ed. G. A. Greenhill, 1844, pp. 13; 14; 307;
and in general concerning Sydenham’s relation to Hippocrates, cf. Payne, op. cit., pp.
222 if.; O. Temkin, Die Krankheitsauffassung von Hippokrates und Sydenham in ihren
Epidemien, Archtv f. Geschichte der Medizin, XX, 1928, pp. 327 if.

* Cf. Sydenham, op. cit., pp. 6; 7. Cf. also Payne, op. cit., pp. 236 if.

* Cf. Johnson, op. cit., pp. 182-183.

* Cf. Payne, op. cit., pp. 192 f. The question put to Sydenham by Blackmore would be
quite meaningless had he been already well established in his calling. For Swift’s mention
of Blackmore, cf. The Prose Works of Jonathan Swift, ed. H. Davis, I, 1939, p. 158;
for Blackmore’s life and the role which he played in his time, cf. T. N. Toomey, Sir
Richard Blackmore, M. D., Annals of Medical History, IV, 1922, pp. 180 if.

* Cf. Payne, op. cit., p. 192.

SYDENHAM AND CERVANTES

attempts to find in Sydenham’s statement an innuendo at Blackmore’s
character or achievements therefore are unconvincing.

Thus one feels almost driven to accept Johnson’s final verdict and to
regard Sydenham’s recommendation of the Don Quixote as “ a transient
sally of an imagination warmed with gaiety, or the negligent effusion of a
mind intent upon some other employment, and in haste to dismiss a
troublesome intruder.” And under this supposition one can hardly refrain
from complaining, again with Johnson: “ The perverseness of mankind
makes it often mischievous in men of eminence to give way to merriment.
The idle and the illiterate will long shelter themselves under this foolish
apophthegm.” For indeed, inconsistent as it might be with his true
opinion, does Sydenham not seem to encourage disdain for medical litera¬
ture when he directs Blackmore to the reading of a novel rather than to
the reading of scientific books? But before the historian and the critic
dismiss Sydenham’s remark as a dangerous jest, before those who are
too lazy to study console themselves with what they call Sydenham’s con¬
tempt for books and protest his example as an excuse for their weakness;
they may find it worth their while at last to take Sydenham’s words as
they stand and not to impute to them any hidden meaning. After all, he
did not advise against the reading of books or against any study. Asked
by Blackmore what books he should read to perfect himself in practice,
Sydenham referred him to a book, the Don Quixote. He affirmed that he
liked this book, that he was still reading it in his mature years, and he
counseled Blackmore to read this work if he aspired to become a good
doctor. Apparently Sydenham considered the Don Quixote a piece of art
worthy of the attention and praise of the physician. There must have been
some reason for his delight in the novel of Cervantes. Besides, granted
that he spoke in a jocular mood and somewhat out of tune when he recom¬
mended to Blackmore the Don Quixote instead of the treatises of Hippo¬
crates, the question arises why he chose this work of fiction and not any
other; what, in his opinion, a physician could possibly learn from the
adventures of the Knight of the Mancha. If one heeds Sydenham’s
injunction; if one peruses the Don Quixote and reflects, as a thoughtful
reader ought to do, on the method employed by the author ir writing his
work and on the purpose to which he devotes it, then the true import of
Sydenham’s puzzling words will perhaps become apparent.

Cervantes, in the introduction to his immortal story, pretends that for

** Cf. Johnson, op. cit., p. 182; the same, Livfs of the English Poets, ed. G. B. Hill,
II, 1905, p. 236 [Blackmore].

LUDWIG EDELSTEIN

some time he was hesitant about publishing it. Once, he says, he even
arrived at the decision that his manuscript should never see the light of
day; for it seemed to him to be lacking in scholarly trimmings. But then,
he continues, a friend of his persuaded him to change his mind. He pointed
out that long quotations from learned authors, the whole paraphernalia of
erudition, were quite useless for this history of the valorous and witty
knight-errant: “ Onely it hath neede to helpe it selfe with imitation, for
by how much the more it shall excell therein, by so much the more will
the worke bee esteemed.” Cervantes, in other words, was intent on
representing reality as it was, on imitating nature. Nor did Sydenham’s
contemporaries fail to notice the realistic background of Cervantes’ work.
Locke wrote: “ Of all the books of fiction, I know none that equals
‘ Cervantes’s History of Don Quixote,’ in usefulness, pleasantry, and a
constant decorum. And indeed no writings can be pleasant, which have
not nature at the bottom, and are not drawn after her copy.” ** Now
Sydenham, for whom the apprehension of the nature of diseases was the
main task of medical inquiry, demanded that “ in writing the history of a
disease . . . the clear and natural phenomena of the disease should be
noted—these, and these only. They should be noted accurately, and in all
their minuteness; in imitation of the exquisite industry of those painters
who represent in their portraits the smallest moles and the faintest
spots.” “ Under these circumstances, is it astonishing that Sydenham
should have called the Don Quixote a good book ? What he himself tried
to do in his writings, Cervantes, the poet, had accomplished in his work:
he had portrayed nature without omitting the smallest detail. There was
a natural affinity between the two authors, in their aims no less than in
their methods and even in their language. Well may Sydenham have said
of his treatises what Cervantes says of his tale: “ Onely endeavour to
deliver with significant, plaine, honest and welordred words thy . . .

** Cf. The History of Don Quixote of the Mancha, translated by Thomas Shelton,
ed. J. Fitzmaurice-Kelly, I, 1896, p. 10 [The Tudor Translations, XIII]. I am quoting
Shelton’s translation which Sydenham must have used—the second English translation of
the Don Quixote made by J. Philips, 1687 (cf. J. Fitzmaurice-Kelly, The Life of Miguel
de Cervantes Saai’edra, 1892, p. 340) appeared only two years before Sydenham died—
because I do not want to read into Cervantes’ text a meaning which Sydenham would not
have known.

**Cf. Some Thoughts concerning Reading and Study for a Gentleman, The Works of
John Locke, III, 10th ed., 1801, p. 275.

^*Cf. The Works of Thomas Sydenham, translated by R. G. Latham, I, 1848, p. 14
[The Sydenham Society]. Cf. also O. Temkin, Thomas Sydenham und der Naturbegriff
des 17. Jahrhunderts, Neuburger Festschrift, 1928, pp. 1 ff.

SYDENHAM AND CERVANTES

discourse, expressing as neere as thou maiest possibly thy intention, mak¬
ing thy conceites cleare, and not intricate or dark.” **

If thus it is easy to discern why Sydenham was fond of the Don Quixote,
it seems no less understandable that, given his point of view concern¬
ing medicine, he should never have ceased to read Cervantes’ novel and
should have admonished other physicians to read this book as a means of
preparation for their own task. What Sydenham detested most in the
sttidy of diseases was the intrusion of theories. In the same moment in
which he demands from the investigator that he cling to the simple and
complete description, or rather copying of nature, he urges upon him:
“ In writing the history of a disease, every philosophical hypothesis what¬
soever, that has previously occupied the mind of the author, should lie in
abeyance. ... No man can state the errors that have been occasioned
by these physiological hypotheses. Writers, whose minds have taken a
false colour under their influence, have saddled diseases with phenomena
which existed in their own brains only; but which would have been clear
and visible to the whole world had the assumed hypothesis been true. Add
to this, that if by chance some symptom really coincide accurately with
their hypothesis, and occur in the disease whereof they would describe the
character, they magnify it beyond all measure and moderation; they make
it all and in all; the molehill becomes a mountain; whilst, if it fail to tally
with the said hypothesis, they pass it over either in perfect silence or with
only an incidental mention, unless, by means of some philosophical
subtlety, they can enlist it in their service, or else, by fair means or foul,
accommodate it in some way or other to their doctrines.”

Now Don Quixote, as Cervantes says in the very beginning of his
story, was in the habit of plunging himself deeply into the reading of
books. ” His fantasie was filled with those things that he read. . . . And
these toyes did so firmely possesse his imagination with an infallible opin¬
ion, that all that Machina of dreamed inventions which he read was true,
as he accounted no History in the world to be so certaine and sincere as
they were.” Consequently, when for the first time he ventured out into
the world, “ our Knight Errant esteemed all which he thought, saw, or
imagined, was done or did really passe in the very same forme, as he had
read the like in his bookes.” This is the reason why he fights with
windmills. It is because for him “ dreams are facts and facts are

" Don Quixote, op. cit., p. 11.

“ Sydenham, op. cit., p. 14.

“Don Quixote, op. cit., pp. 25; 31.

LUDWIG EDELSTEIN

dreams,” because for him everything takes on the color of his imagina¬
tion, of the fancies of his brain, that he constantly mistakes reality. He
overlooks all instances which speak against him, or fits them, as best he
can, into his vagaries, just as do the believers in windy hypotheses against
whom Sydenham inveighs. And pitifully he suffers shipwreck in his
undertaking just as, in Sydenham's opinion, the adherents of physiological
theories are bound to do when they attempt to understand nature.^

Only at the end of his life does Don Quixote realize what a fool he was.
Nothing remains for him but to praise the mercy of God through whom
he has at last, though much too late for this life, regained “ a free and
cleere judgement, and nothing overshadowed with the mysty clouds of
ignorance, which the continuall reading and plodding on bookes of
Chivalry had over-cast mee withall.” The reader of Cervantes’ book is
supposed to experience the same conversion, but while there is still time
to charter a new course. Thus Cervantes’ friend says in the introduction
to the Don Quixote: “ Let thy project be to overthrow the ill compiled
Machina, and bulke of those Knightly Bookes, abhorred by many, but
applauded by more. For if thou bring this to passe, thou hast not atchieved
a small matter.” Thus the poet reiterates in closing his account: “ I never
desired any other thing, then that men would utterly abhor the fabulous
impertinent and extravagant bookes of Chivalries: And to say truth, by
meanes of my true Don Quixote, they begin already to stagger; for,
undoubtedly such fables and flim-flam tales will shortly fade, and I hope
shall never rise againe.”*®

I suggest then that Sydenham read the Don Quixote as a kind of cathar¬
tic and preventive medicine for the physician and that he wanted others to
read the book to the same end. Whether the masterpiece of Cervantes is
but the biography of a madman who through bitter trial comes to his
senses as one is led to believe by the poet’s words; whether the fabula
docet of the well-nigh fathomless story is different from what it purports
to be or something more in addition, this is not the place to arg;ue. It
suffices that the book can be understood as Sydenham seems to have under-

Fitzmaurice-Kelly, The Life of Cervantes, p. 271.

As far as I am aware, John D. Comrie, Selected Works of Thomas Sydertham, 1922,
p. 2, is the (Nily one who has in any way connected Sydenham’s remaric with the meaning
of the Don Quixote. He says that the words in question indicate “ at once his contempt
for the medical literature of the time and the knowledge to be gained from Cervantes’s
romance as to the foibles of mankind.” I do not believe that Sydenham was indulging in
such generalities but rather that he thought of the physician and his specific task.

Cf. Don Quixote, op. cit., IV, p. 270.

*• Cf. Don Quixote, op. cit., I, p. 11; IV, p. 278-

SYDENHAM AND CERVANTES

stood it and that it was generally understood in this way in Sydenham’s
time.** Locke expressed his astonishment that “after the pattern Dr.
Sydenham has set them of a better way, men should return again to the
romance way of physic.” And he added: “ I see it is easier and more
natural for men to build castles in the air of their own than to survey well
those that are to be found standing.” ** It is this human instinct for self-
deception against which Sydenham warned Blackmore, an inclination par¬
ticularly dangerous for the physician. Beware of your imagination, he
wants to say; get rid of your fancies; let facts be facts; do not view nature
in the light of your preconceived ideas; otherwise you will be all your life a
Quixote, a “ Knight of the Woeful Countenance.”

For the history of the interpretation of the Don Quixote, cf. e. g. W. J. Entwistle,
Cervantes, 1940, pp. 147 ff. For Cervantes in England, cf. G. Becker, Die Aufnahme des
Don Quijote in die englische Literatur, Palaestra, XIII, 1906; R. Schevill, On the
Influence of Spanish Literature upon English in the Early 17th Century, Romanische
Porschungen, XX, 1907, pp. 604ff.; also J. Fitzmaurice-Kelly, Cervantes in England,
Proceedings of the British Academy, vol. II, 1905.

"Locke to Thomas Molyneux, 20. January, 1692-3; cf. H. R. Fox Bourne, The Life
of John Locke, II, 1876, p. 243.

O MUSEU DE PSIQUIATRIA E DE ANTROPOLOGIA
CRIMINAL ORGANIZADO POR CESARE
LOMBROSO

CARLO FOA

As intuiqoes do genio brotam de improviso como flores novas num
campo onde jamais haviam aparecido. Ha uma epoca da vida, uma idade,
na qual, de preferencia, se manifesta o genio? Parece fora de duvida que
as intuiqoes matematicas e musicais sejam muito precoces, como proprie-
dades congenitas do espirito humano, o que nao exclui que a obra prima,
mesmo nesses campos da genialidade Humana, possa aparecer na idade
inadura e ate na velhice. Giuseppe Verdi criou Falstaff quando tinha 80
anos, e Falstaff e talvez a musica mais juvenil e original do mestre imortal.
Falase que as intui^oes geniais nas ciencias naturals sejam fruto de longa
reflexao, constituindo portanto privilegio da idade madura. Assim nao
foi quanto a ideia fundamental de Cesare Lombroso, que constituiu a base
de sua imensa criaqao cientifica. Ja quando estudante de Medicina em
Pavia, Lombroso comeqou a colecionar e a descrever cranios de criminosos
c de loucos, e sens primeiros estudos sistematicos de antropologia e de
ctnologia comparada remontam a ef>oca na qual, como medico-militar, teve
a oportunidade de assujeitar milhares de soldados a um atento exame e a
rigorosas medidas antropometricas. O Asilo Psiquiatrico de Pavia hos-
pedou o primeiro museu antropologico do mundo, enriquecendo-se cada
vez mais de cranios e de cerebros de loucos e de criminosos. Quando
Lombroso passou a ser catedratico de Medicina Legal em Turim, para ai
iransportou o Museu cuja fama ja se espalhara dentro e fora dos limites
da patria, chamando a atenqao de cientistas, biologos, medicos e legisla-
dores, dos quais o interesse nao se limitou a pura admiraqao, mas os levou
a concorrer para a ampliaqao do Museu, enviando donativos de material
antropologico por ele recolhido.

Foi em 1892 que Lombroso pode organizar o Museu em forma defini-
tiva, enriquecendo-o com o material que nos anos precedentes um seu aluno
(Beltranni-Scalia) havia colecionado na Penitenciaria de Roma, “Regina
Coeli.” Os Ministerios do Interior e da Justiqa, daquele tempo, autori-
zaram todas as penitenciarias aenviar para Turim os objetos que pudessem
constituir documentos carateristicos da psicologia anormal, ou “ corpos do
crime,” e que apresentassem qualquer interesse criminologico.

Foi assim definitivamente organizado em sede condigna aquele Museu,

O MUSEU DE PSIQUIATRIA CRIMINAL

oficialmente inaugurado por ocasiao do primeiro Congresso de Medicina
Legal em 1898, e que traz o celebrado nome de seu fundador. Quern
quisesse escrever a historia da Antropologia como ciencia autonoma, que
deu origem mais tarde a dois ramos principals: o que faz parte da
Etnografia e o que constitui a base da Biotipologia morfologica e da
niodema Biometria, nao se deveria esquecer de que, neste conjunto de
l)esquisas levadas a cabo na Italia no fim do seculo passado e no comedo
do seculo XX, os nomes de De Giovanni, Sergi e Viola, devem ser pre-
cedidos pelo nome do verdadeiro fundador da Antropologia, que foi
Cesare Lombroso.

E’ qualidade essencial da obra do genio, a de parecer tao intuitiva e tao
simples, que custa acreditar em sua originalidade. O genio age como
transformador de energias que sempre existiram e que, todavia, ninguem
concretizara em ideias ou em formas por todos compreensiveis. Nao ha
hoje ensino de Medicina Legal no mundo que nao considere patrimonio
definitivo daquela ciencia os fatos e as doutrinas lombrosianas; nao ha
codex penal de qualquer na^ao que nao tenha por base, seja ate para os
negar parcial ou totalmente, os conceitos lombrosianos da criminalogia
como fruto de alteragao mental. Nao ha Instituto de Medicina Legal e
de Psiquiatria no mundo que nao possua coleqao mais ou menos parecida
com a do Museu “Cesare Lombroso,” coleqoes as quais no universo
inteiro se deveria atribuir o nome de Lombroso, assim como todos os
sanatorios para tuberculosos deveriam ter (e de fato inumeros o tern)
pelo menos uma sala dedicada ao nome imortal de Carlo Forlanini, o
inventor do pneumotorax. Sao nomes que nao mais constituem gloria
duma na^ao, mas patrimonio imortal da humanidade.

No Museu “Cesare Lombroso” existe verdadeiro cimdio de inesti-
mavel valor historico. Tratase do cranio possuidor da “ fossa occipital,”
cuja observaqao constituiu ponto de origem da intui^ao lombrosiana sobre
os caracteres regressivos ou degenerativos que acompanham as alteraqoes
psicologicas e a criminalidade. As vitrinas do Museu, onde estao expostos
objetos fabricados pelos proprios criminosos nas penitenciarias, constituem
documentos psicologicos das tendencias destes espiritos desviados da nor-
malidade e dominados por ideias obsessas ou confusas. As vezes se trata
da reproduqao artistica da cena do crime que levou o criminoso a cadeia,
ou da do tribunal que o julgou. Noutras vezes, de objetos reveladores
de tragicos contrastes que se agitam no espirito do criminoso, como o
crucifixo-punhal, onde se resume um conjunto absurdo de sentimentos os
mais antagonicos: o sentimento religioso e a tendencia sanguinaria. A sala
onde estao expostas as ceramicas executadas por criminosos e uma das

CARLO FOA

mais ricas e interessantes do Museu. Ai encontramos as mais variadas
expressoes do espirito anormal, que se revela por cenas exquisitas, crueis,

sarcasticas ou obscenas. Num vaso de ceramica o homicida Fusil quis

representar num lado o proprio suicidio, pendurado a janela de sua cela,
e, no outro lado, a cena de sua vitima que ele escondera num armario
apos o homicidio.

A colegao mais curiosa dentre as que figuram no Museu “Cesare
Lombroso ” e aquela que Ihe foi cedida pelos herdeiros de afamado religio-
maniaco, um tal Lazzaretti, que, por fatal engano, fora morto a tiros pela
Forqa Policial, quando estava chefiando inocente procissao religiosa,
tendo-se transformado, de modesto carroceiro, em vigario de Deus.
Costumava vestir um mantel de purpura marcado por simbolos particu-
lares, a cabeqa cobetta por uma tiara omamentada de flores. Levava um
bastao de comando, formado f>or cinco peqas em honra dos Evangelistas,
com sinais misticos. Fazia-se seguir por estandartes com disticos, cruzes,
qoroas, emblemas, figuras de pombos, de aguias, de cobras, de cavalos
com asas—representaqoes das alucinaqoes que afligiam seu espirito para-
noico. Um enorme sinete servia para marcar, a fogo, a prdpria p)ele e a
de seus comparsas.

* « #

Poucos anos atras se constituiu em Chicago, por ocasiao da Exposi^ao
Mundial, uma exposi^ao dos documentos principals da Histdria Universal
das grandes descobertas cientificas do seculo XIX.

A Italia compareceu aquele certame com a documentaqao iconograbca,
cimelios, etc., referindo-se entre outras as obras imortais de Volta, de
Pacinotti, de Marconi, de Galileo Ferraris, de Golgi, de Grassi, de
Forlanini, de Mosso, de Lombroso.

A atividade de Cesare Lombroso nao cessou ate os ultimos anos de sua
vida. Ate o fim ele conservou o espirito dotado de originalidade criadora.
Suas publicaqoes cientificas, difundidas em todas as linguas do mundo,
atingiram numero bastante relevante, bgurando o frontispicio das princi¬
pals delas na Exposi^ao de Chicago. “ Exegi monumentum aere peren-
nius.” Eis a epigrafe que poderia ser colocada embaixo daquela figura,
que representa verdadeira apologia da obra imortal de Cesare Lombroso.

I POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF

PHYSICK AND HIS ANGLIC A HISTORIA *

J. F. FULTON
Introduction

In the heyday of the Italian Renaissance men flocked from every land
to Italy to breathe the free and vigorous atmosprfiere of art, learning and
liberal thought. In 1486 or thereabouts Thomas Linacre, humanist and
physician of England, settled in Italy and remained there for some thir¬
teen years, devoting himself to Greek as well as to medicine and to other
scholarly pursuits. He resided at Florence, at Rome and finally at Venice
where he helped Aldus Manutius with his great edition of the Greek
Aristotle (see vol. 3, /. * 2, 1497), and the editio princeps of Galen (vc4.
5, lib. pars 5, 1525).^ On his journey back to England Linacre paused on
a high Alpine pass,* overlooking the land to the South which he had ccwne
to know and love, and there built a small altar to the land of his studies,
his Sancta Mater Studiorutn. This was in 1499.

As if responding to this gesture of grace and feeling, a young Italian
scholar, little more than a year later, made his way across the Alps to
settle in England carrying likewise the bright spirit of the Renaissance.
This was one Polidoro Vergilio, known also as de Gastello or Castellan,
but in England as “ Polydore Vergil of Urbino.” He had come as a Papal
appointee to collect Peter’s pence, and he remained for nearly fifty years,
becoming successively Rector of Church Langston, Leicestershire, Pre¬
bendary of Nonning^on, Archdeacon of Wells, and Prebendary of Brent;
and he weathered many a storm of political and religious controversy

1 during the reigns of Henry VII and Henry VIII. He emerged not only
as the first historian of medicine after the advent of printing, but the first
widely recognized historian of England, his adopted country. I like to
I think that this de Gastello of the 16th century is in a real sense the pro¬
totype of the travelled scholars of a later age—of men such as Arturo

* Based on an unpublished paper communicated in August 1932 at the IXth Inter-
f national Congress of the History of Medicine in Bucharest, at which I first had the

privilege of meeting Professor Castiglioni. JFF
1 ^ Thus he says: “ Thomas linacrus Aldi nostri contubemio ad aliquos annos usus.”

Contubemium is literally a tent-sharing and may mean simply companionship, but it
I probably means that he lived with Aldus, used-the-same dwelling, for some years.

■ * Probably St Bernard.

J. F. FULTON

Castiglioni, who 400 years later still embody that glowing Renaissance
spirit of scholarship and learning which will ever be the heritage of edu¬
cated men. Like Polydore his learning is encyclopedic; like Polydore, he
is a great linguist; like Polydore, he is a medical and also a general his¬
torian; like Polydore, he came from the hospitable Italian scene. The
parallel will be all the more striking as the story of the great Renaissance
historian is unfolded.

Born at Urbino, probably in 1470, of a scholarly family, little is known
concerning his education save that he studied both at Padua and
Bologna and that, prior to settling in England, he served as secretary to
his patron, the Duke of Urbino. While at Padua he wrote two books—the
first, Proverbiorum libellus, was issued at Venice in 1498. The second
book, also issued at Venice in 1499 from the press of Cristoforo de Pensis,
came to be one of the most widely known historical writings of the 16th
and 17th centuries. This, De inventoribus rerum libri tres, a small quarto
volume of 88 leaves (Fig. 1), gave, among other things, one of the
earliest and most valuable accounts of the history of printing, and con¬
tained, in addition, the first, albeit brief, account of the history of medi¬
cine. Confined to three chapters in a book devoted to the origins of all
the sciences and some of the arts, I believe it entitles Polydore Vergil to
be designated the first medical historian of modern times. John Ferguson,
the Scottish bibliographer of the last century, in attempting to resurrect
this work made a study of De inventoribus rerum and was able to trace
some 90 separately printed editions and translations, as well as 16 possible
and 11 doubtful ones, the majority of which appeared in the 16th century.
Some years ago Ferguson’s unfinished bibliography of Polydore’s book *
was turned over to me by Miss Elizabeth H. Alexander, his literary
executor, and with Mrs. John Peters’ assistance a careful study has been
made of the manuscript; one edition unknown to Ferguson has been
added and we are about to make a careful census of all known copies, since
many editions are of extreme rarity.

Polydore Vergil modified some of the later editions of De inventoribus
rerum, notably those of 1528-29 (Fig. 2) and 1544, but none thereafter,
and translators of the book into German (Fig. 3), Italian (Fig. 5),

‘Ferguson’s paper on the English translations of Polydore attracted wide attention.
Sec Ferguson, J. Bibliographical notes on the English translation of Polydore Vergil’s
work “ De inventoribus rerum.” Archaeologia, 1888, 5 /: 107-141; also Bibliographical
notes on histories of inventions and bodes of secrets. Pt. 2. Trans. Glasgow Archeol.
Soc., 1883, 229-272; Notes on the work of Polydore Vergil “ De inventoribus rcrum.”

Isis, 1932, 17 : 71-93.

/Ue^jTO.T-W.

Fig. 1.

Two pages from the 1499 edition of Polydore Vergil’s De invent oribus rerutn libri tres.
showing the beginning of chapt. xix, “ Quis primus Medicinam muenent.
Fourteen copies of this, the first edition, have been traced.

POLYDORI VEROILII DE INVf'M*
tonbus rcmm prior cditio^tribusphnus cotenea
Ubris« ab ipib autorc rrcc^ta , ft locupUtata,
vbi viia (ft materia ficpoiaie*

CVI EDITIONl ADOLVTINAVIT
Jnftitiita omnia noftr{ Chriftianac reh'eionis ab'a
nbnvcgentift^ aceonun primordia vnoiquedib';:
genter qiiatfita: quae quinque pofterioribus libris
condnmtur*

Adiedus eft ft indez^omnia quae in hoc opete tra#
^Untiu>i(ti( literaxia i ndicans*^

PARISHS*

EXOFFICXNAROBERTl STEPHANl
M*0*XXVIII*

Fic. 2.

Title-page of the 1528-9 edition of De inventoribus rerum in which Polydore introduced
textual modifications. The colophon runs: Imprimebat Robertus Stephanus
in sua ofiicina Ann. M. D. XXIX, VI Idus lanuar.

The Bodleian copy reported by Ferguson reads Co[mJpIexa for contenta; undecumque
for undique ; edocens for indicans in the title. Renouard gives title as in figure.

POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF PHYSICK 69

French (Fig. 4), Spanish, Dutch and English at times took liberties with
the text. One edition, that of 1576, was expurgated by order of Gregory
XIII and reissued with a new title-page in 1585. Comparison of the
chapters devoted to medicine (xix to xxi of Book I of the 1499 edition)
indicate that Polydore did not revise this section, even though the English
translator, Thomas Langley, made minor modifications.

His history of England,* published in 1534, brought abuse upon his
head from men in high station and the contempt of many scholars: he was
an Italian, they said, who did not know English. And yet there can be
little doubt that Vergil conscientiously examined a large body of signifi¬
cant source material and he did much to replace legend by documented
evidence. Indeed, as a general historian his name looms large even today.*

De Inventoribus Rerum

De inventoribus rerum is quite* a different work. Ferguson (1888, p.
117) has said of it:

Although no longer authoritative. Vergil’s work, De Inventoribus Rerum, is still
full of interest. It appeals to the historian of inventions and of customs by being
the first on the subject; to the archaeologist, by its contents and their free treat¬
ment; to the bibliographer, by its own history, by the number of its editions, and
by the variations some of them display; and to the book-lover, by the rarity and
value of copies, especially of the English and early Latin editions, though, indeed,
it would be more correct to say of all the editions and translations. They are all
scarce, some of them extremely so.

The original three books deal with the history of the physical and biologi¬
cal sciences,, and more particularly with the history of the technical
sciences. Apart from the Etymologise of Isidore of Seville in the 7th
century,® there had been nothing like it since the time of Pliny. The nine¬
teenth chapter of Vergil’s first book deals with the history of physick
“ Quis primus Medicinam inuenerit,” and since the book appeared in
1499 this entitles it to be looked upon as one of the first histories of medi¬
cine after the invention of printing. The celebrated bic^raphical diction-

*Anglicae historiae libri XXVI. Indices rerum singularum copiosos et usui egregio
futures, adiecimus. Cum gratia et privilegio Caesarea- Basileae, apud lo. Bebclium Anno
M. D. XXXIIII.

‘Thompson, J. W. A history of historical writing, vol. 1. New York, the Macmillan
Co., 1942. (See especially Chapt. 25).

'Isidore of Seville’s Etymologiae is an encyclopedic compendium of scierce, medicine
and magic first issued in Germany at Strasburg in 1472 (also Augsburg, 1472). Sec
Thorndike, Lynn, History of magic and experimental science, 1929, vol. 1, pp. 632-633.

J. F. FULTON

ary of physicians by Symphorien Champier ’ was published in 1506, and,
while it is generally regarded as the first history of medicine, it is in reality
a biographical dictionary. Polydore Vergil’s book on the other hand,
deals more particularly with the history of therapeutic ideas, with scant
biographical detail. Before describing the contents of Vergil’s chapter on
the history of medicine, a few words may be said concerning the history of
the work itself.

The first three books were printed, as already mentioned in 1499 *
and the last five books were not added until the Basel folio edition of
1521.® From the point of view of the history of science and medicine, the
last five books are of scant interest since they deal with the origin and
the development of the Christian church and its ceremonies and festivals.
Vergil also revised the first three books in the 1528 (Fig. 2) and 1544
editions which appeared during his lifetime; careful collation of the chap¬
ters on the history of medicine has shown that no significant additions
had been made between 1499 and 1528.

English translation : To English and American students of the history
of medicine Vergil’s work is of interest, not only because he was a natural¬
ized Englishman, but more particularly because an English translation or
“ abridgement ” of the De inventorihus rcriitn appeared from the press of
Richard Grafton of London in 1546 (Fig. 6). Actually three issues were
published in the same year. The first bears the date on title-page and
colophon, “ the xvie dale of Aprill, the yere of our lorde M.D.xlvi.” The
second issue has the first two gatherings (f. e., the entire preface) reset
and bears the date “ 25 day of Januarie ” of the same year and in the
colophon the date of April 16th. The third printing of 1546 is an entirely
new printing, reset throughout, and on title-page and colophon has the
date of January 25th. It would appear, as Ferguson points out, that when
the printer decided to reissue the book in January 1546/7 he had a few
copies of the April issue left over and to sell them with his new’ edition he
appended a fresh title-page with the new date and reset the preface. All

’ De tnedicinae Claris scriptoribus in guinque partitus tractattu, Lyons [J. de Campis]
1506.

* Title: Polydori Vergilii Urbincdis De inventorihus rerum libri tres. Colophon:
Polydori Vergilii Urbinatis De inventorihus rerum opus Magister Christophorus de Pensis
impressit Venetiis Anno humanitatis Christi. M. CCCC. LXXXXVIIII. Pridie Kalendas
Septembris. It is a small quarto with signatures a-k", 1“; 1106 is blank.

* Polydori Vergilii Urbinatis Adagiorum liber. Eiusdem de inventorihus rerum libri
octo, ex accurata autoris castigatione, locupletationeque non vulgari, adeo ut maxima feri
pars primae ante hanc utriusque z'oluminis aeditionem accesserit.

Colophon: Basileae ex Aedibus Joan. Frobenii, Mense lulio, Anno M. D. XXL

Fig. 3.

Illustrations from two of the German translations of De inventoribus rerum. Left; The first German translation by Marcus
Tatius, Augsburg, 1537. Right; Also translated by Tatius, published at Frankfort by Weygand Han, without date.

^Polydore

VERGILE histo¬
ric G R AP HE^NOVVEL-
kmenttraduiSi de Latin en
Trancoys , declarant ks in-
uenteurs deschojes <jui out
ejhrc.

On let ueni i ?ant , Chei^ VieolM
du Cbemm , i tenfeigae iu Gry¬
phon £argeut,pret U Ccllege de
Camhrey.

154^.

Fig. 4.

Title-page of unique copy of the French translation of De itwentoribus
rerum. This French translation had not been traced by Fergusoa
The translation is attributed to Guillaume Michel de Tours.

POLIDORO

V I B. G I L I O

DA VRBINO

DE GLI INVENTORI

DELLE COSE,

LibriOtto.

TRADOTTI PER m! FRANCESCO

BALDELLI,

Qm dtu TmiU, Vm CdpitoU,
deUe cofipm mttb'dt .

Naouanente Sumpati con Licenza de’ Superiori.

IN FIORENZA,

PER FILIPPO GIVNTI.
M D X C I I.

Qm LUtox^ i ^ 'Primliffo,

Fig. 5.

Title-page of the second Baldelli translation of the expurgated
Latin edition of De im/entoribus rerum, 1576.

J. F. FULTON

three issues are exceedingly rare.^® The acquisition of a copy of the first
issue from a London bookseller in 1931 gave the impetus for the present
study.

The translator, Thomas Langley, about whom little is known, apart
from the fact that he was a classical scholar, took many liberties with
the text. The chapter on the history of medicine is slightly curtailed.
However, since this text represents the first account in English of the rise
of medicine, it seems worth while to transcribe it in full from the first
edition.

The .xvi. Chapiter.

Phisike, and the partes therof.

Phisike, whiche with remedies provided of God, doth much comforte and cure
men in their maladies and diseases, that brest furth one every side, is thought
worthely to have bene invented of the Goddes. For it is supposed that Mercurie
founde it among the Egipcians, some saye it was Apis their god: or Arabus sonne
to Apollo. Some referre it to Apollo himselfe. because the moderate heate of the
Sunne is banisher of all sickenesse. Clemente dooeth attribute the fyndyng of it to
the Egipcians in generall & the amplifiyng and enlargyng of it to Aesculapius
whiche besyde other thinges, founde the pluckyng out of teth. Notwithstandyng,
whosoever found the notable knowlage of medicines, it is no faile but it was per¬
ceived by what thinges were wholsome and what unwholsome. And as they observed
howe the sicke folkes used their diete and marked how some for gredynesse did
eate by and by, and some forbare theyr meate because of faintnesse of their
stomake, and so were releved, they learned that abstinence was a helper and
furtherer of health: and by lyke observaunce other preceptes of Phisike were
gathered.

It hath thre partes, one of dietyng another of Medicines, the thirde of surgery,
for by one of these .iii. waies every desease is releved. But for so muche as it is
uncertayne and often chaungeth, it ley in extreme darkenesse tyl Hippocrates dyd
renewe it: and wher as they had a custome that the pacient beyng restored to
health should write in the temple of the god that healped him, both his name and
the maner of healyng, that the example might helpe the like desease; out of all
such precedences he gathered precepts of Phisike, and brought it fyrst to a formall
arte.

In Rome Archagathus of Peloponesus was fyrst Phisicion, ye ccccc, xxxv, yere
of the Cytie, Lucius Emilius and Marcus Livius beyng Consuls, and was made
fremanne of the cytie, which was fyrst made a Surgion or wounder, after for the

“ Of the first (STC 24656) there are copies in tlie Newberry Library, Chicago, British
Museum, Bodleian, Fulton; of the second (STC 24654) in Library of Congress, British
Museum, Cambridge University Library; of the third (STC 24655) in Library of Con¬
gress, Henry E. Huntington Library, San Marino, (3al., University of Chicago, Princeton
University, Folger Museum, Washington, British Museum, Cambridge University Library.
Ferguson says “ There is a copy in the Ewing Collection, Glasgow University Library.,.
Sept. 23, 1832. A copy acquired today agrees exactly with that at Glasgow.”

issued at the press of Richard Grafton, London 16 April 1546 (STC 24656)

J. F. FULTON

sharpenesse of his cuttyng & seryng, he was named a butcher or execucioner and
murtherer, and afterward when the nombre begane to encrease they were expulsed
out of Rome and banished by Marcus Cato as Plinie telleth in xxxvi booke.

In Egypte and Babilon they used no Phisicians, but brought the sicke persons
into the stretes and common places, that the men, whiche passed by, might tel
them what maner diete or meanes thei theimselves had used in the lyke desease
to escape it: nether was it lawful for anye man to passe by tyll he had commoned
with the pacient. In the latter dayes the Egyptians distributed the arte of Medicines,
in such sorte, that every desease had a diverse Phisician to minister in it, as one
for the eyes, one for the head, other for the entrayles, and semblably other for other
sickenesse and so it come to passe that al places were ful of Phisicians.

In this arte excelled Cassius, Calpitanus, Arimcius Rubrius, Antonius Musa,
Galenus, Avicenna.

The .xvii. Chapiter.

The inventours of Herbes medi-
cinable, what remedies menne |

learned of beastes.

Nature doubteless, the mother and governour of al thinges dyd create Herbes,
as maye appeare by manye examples, partely by the delectacion, and partely for
the wealthe and preservacion of mennes bodies. For Xanthus an historiographer
(as Plinie recordeth) telleth how a Dragon revived his young faune, that was
slaine, by the vertue of an herbe called Balin: and the Hechewal if a wedge bee
driven into the hole of her nest (for she maketh her neste in the hole of a tree
that she woorketh with her beake) compelleth it to fall oute with an Herbe that
she knowethe: and some of the Indians live onely by Herbes, Appianus wryteth,
that the Parthians, which Antonie put to flight, constrayned by extreme famyne,
chaunced too eate a certayne Herbe, whose nature was to make theim that eate it,
too forgette all other thynges, and onely digge up stones, as if they would go about
some greate endevoure, and after suche extreme travail died. Of such medicines
made with Herbes. Chiron sonne to Saturnus and Phillara was the fynder, and
devised also salves for woundes, soores, and byles, albee it some thynke it was
Appollo, some referre it to his sonne Aesculapius, whom Chiron brought uppe,
some to the Samothracians. But I suppose they attributed the invencion of it to
Chiron by cause he found the Herbe Centaurie, wherewith he healed the wound
that he had by Hercules shaftes fallyng on his foote, as he was handlyng of his
weapons: notwithstandyng Celsus saieth that the arte of Phisike is verye aunciente,
but he maketh no mencion of the authour of it, onely he sayeth, Asclepiades, whiche
was an excellente Phisicion, dyd abholishe the use of it for somuche as it annoyed
the stomacke and engendered evil humours Mercurie founde the use of Moly,
Achilles Yarowe, Esculapius, Panace and sondery menne founde sonderye Herbes.
Medicines of Hcmy, Sol the sonne of Oceanus invented: and beastes taught men
certayne Herbes necessarie for medicines. As the Harte striken with an arrowe
driveth it out with Detany: & if he be stynged with a Spider, he healeth him selfe
with eatyng Pilles of a certayne herbe named Cancer. Selandyne, that is a sov-
eraigne herbe for the sighte, was percevued by the Swallowes, whiche heled the
eyes of their yong ones with it. The Snaile or Tortoise, redy to fight with the

POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF PHYSICK 77

Scrpente, armeth him sclfe with Savery or Maioram. The Bore in his sickenes
cureth himselfe with the Juye. Of the water Horse in Nilus, menne learned to let
blodde. For when he is coarsye and vulustye he seketh by the river syde the
sharpest reede stalkes, and striketh a vayne in his legge against it with great
violence, and so easeth his bodye by, such meane: And when he hath done he
covereth the wound in the mudde.

The Ibis a byrde much lyke the storke, of the same countree taught Phisiciens
to minister clysters: For when she is ful she purgeth herselfe with her croked
beake at the foundament. The wesyl in chas3mg the serpente preserveth her selfe
with Rue and the storke with Organye. In Grece Orpheus, Museus, Dioscorides,
in Rome Marcus Cato, Pompeius Leneus wrote of the nature of herbes. In this
tyme Plinie thinketh, that this arte was fyrst received among the Romaynes.

The xviii Chapiter.

The beginnyng of Magike. Drivyng
out of spirites, Charmes, prophe-
ciyng in sundry maners.

Magike had it beginning of medicine, and was the invencion of Zoroastres kyng
of the Bactrians, whiche reigned .viii. L. yere after the siege of Troy, the same
tyme that Abraham and Ninus reigned, aboute three M. L. Ixxxv. yeres after the
creacion of the worlde. Lactantius and Eusebius thynke it was set furth among
other develishe sciences by the evil spirites, and Plinie calleth it of al artes the
moost deceytful. It is compacte, of medicine or phisike, supersticion, and the
mathematical artes. The Thessalonians most specially were slaundered with the
frequent use & practisyng of this facultie: The writer of this art was Hosthanes.
And Pythagoras, Empedocles, Democritus, Plato with divers other sayled in far
countries to learne it: wherin Democritus was most famous LLL. yere after the
cytee was builded, in whiche time Hippocrates published the facultie of Phisike.

The maner to dryve oute spirites out of men that were possessed with them, and
charmes to heale corporal maladies, kyng Salomon taught, as Josephus witnesseth:
and he sawe it doone by Eleazar in his tyme afore Vespasianus then emperour.
The maner to heale them was suche: He put to the nose of the possessed man a
ryng wherein was enclosed a roote that Salomon had shewed, & so dreve out the
spirite, and straight way the man fel doune: then he coniured him with suche
orisons and exorcismes as were appointed by Salomon, to banishe the spirite out
of ye Demoniake.

The sages or wyse men of Persye, whiche in theyr langpiage bee named Magi,
beyng wholy addict to the honoryng of their false goddes, came to suche extreme
folye, that they professed openly, that they could not onely by the observacion of
ye sterres know thynges to come, but also by other pretensed artes and mumblyng
of a fewe woordes, they could do & bryng to passe anyethyng that they would.

Of them were invented these sixe kyndes of Magike, Necromancye, whiche is by
raisyng uppe of deade men, as in Lucane one raysed from death telleth the
adventures of the battaile of Phatsalus.

Pyromantie, that telleth thynges by the fyre and lightnyng as Tanaquilla the
wyfe of Tarquinius Priscus, prophesied that Servius Tullius should be kyng of

78 J. F. FULTON

Rome because she se the fyre environ his head. The fyndyng of this Plinie referreth
to Amphiaraus.

Aeromantie that is a kynd of proirfieciyng by the ayre, as by fliyng, fedyng,
singyng of byrdes and straunge tempestes of wynd & hayle. Hydromantie, was
propheciyng by water: as Varro writeth that a chile did se in the water the Image
of Mercury, whiche in L. and fiftie verses told al the chaunce of warre against
Mythriadates kyng of Pontus.

Geomantie, was a divinacion by openyng of the yearth.

Chiromantie, is a coniecturyng by beholding the l)mes, or wr)mcles of the handes
called commonly Palmistry.

All whiche vayne illusions, & false persuasions, it becometh al true christiens to
eschewe and abhorre.

The .xix. Chapiter.

Two kyndes of divinacion, sothsaiyng
castyng lottes, and readyng of dreames

Cicero maketh .ii. kindes of divinacions, _ one natural and another artificial.
Natural is that, which procedeth of a certeine concitacion, stirryng, & commocion
of the mynde, that chaunceth sometyme to men when they be in dreames or slepyng:
sometymes when they prophesye in a maner of fury & ravishyng of the mynde,
as it dyd to Sibilla & diverse other religious persons: Of this kind were oracles of
Apollo and lupiter Hammon. Albeit they were often false, because thei came of a
devilishe polycie, & mans subteltye: but suche as come of the holye ghost and not
of a phrenetike madnes be true.

The artificial! consisteth in those thynges whiche come of coniectures, olde
consideracions, and observaunces of the entrailes of beastes, fliyng of byrdes,
castyng of lottes.

The regarding of the bowels of beastes beganne among the Hetruscians: For as
it fortuned a manne that plowed, to rayse up a deaper forowe then he was wonte
to do, all sodeynly arose out of the yearth one Tages, that taught them al the feates
of sothsaiyng, but Plinie sayeth one Delphus found it.

The divinacions by lokyng on the fedyng of byrdes Theresias a Thebane devised,
Caras fyrst marked the chitteryng of them, and Pythagoras observed theyr fliyng.

Orpheus added the divinacion by other beastes. What store we ought to set by
suche divinacions, Mossolanus a Jew techeth us. When he was in the warres,
a certaine prophete commaunded every man to stand styll tyl he had taken a coniec-
ture of the bird that flowe by: but Mossolanus toke prively a bowe and shafte and
kylled the byrde, wherewith the wysarde & diverse other were displeased, then he
sayd to them. Why doate you so ? can ye byrde, whiche knoweth not of her owne
death, tel us the casual adventures of oure ioumey? For if she had had any fore
knowledge, she wold not have comon hether to have bene kylled of me.

Castyng of lottes, Numerius Suffusius devised first at Prenest.

The expoundyng of dreames Plinie ascribeth to Amphiction, but Trogus assigneth
it to Joseph sonne of Jacob, Clement sayeth the Telmessians found it. But al these
were invented to seduce men with supersticious errour and for the commoditee of
them that use it.

POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF PHYSICK 79
History of England

Polydore had settled in England, probably in 1502, and in 1505 King
Henry VII with whom he had come to be on intimate terms, commis¬
sioned him to write a history of the realm. He had meanwhile received a
number of ecclesiastical benefices in addition to his papal appointment,
and in 1510 he became a naturalized Englishman. Polydore’s years under
Henr>' VII were peaceful and he evidently devoted much of his leisure to
the history. During these years he lived the greater part of the time in
London and came to know many of the scholars and literary lights of the
day, including Thomas More, Tunstall, Fox, Lily, Linacre, Colet and
Grocyn. and he also learned to know Thomas Wolsey—perhaps a little
too well. In February 1514 he made a trip to Rome, and Wolsey had evi¬
dently requested his aid with the Pope in obtaining a cardinal’s hat.
Polydore in a letter from Rome, which was intercepted, indiscreetly referred
to Wolsey’s ambitions; and after returning from Rome Wolsey brought
charges against Polydore for vilification of character and he was
imprisoned in the Tower. Pope Leo X, as well as Oxford University,
addressed a petition to Henry XTIII requesting Vergil’s release, but he
remained incarcerated for more than six months, being eventually released
the day before Christmas 1515. Looking back now at the episode, the
Cardinal would have been a wiser man had he not attempted to imprison
an historian. Had Wolsey but served his God with half the zeal he served
his King, he would not in his age have found himself left for posterity to
the judgment of an irritated Polydore, for Polydore gives the Cardinal a
thoroughly bad character in his history, and Shakespeare, as well as Eng¬
lish school-books for the next four hundred years, repeated the unsavory
characterization. Polydore must have been on better terms, however,
with another prelate, since in 1525 we find him dedicating the Opus novum
of Gildas, which he and Robert Ridley had edited, to Cuthbert Tunstall,
then Bishop of London.

Vergil seems to have reestablished himself in the King’s favor, if not in
Wolsey’s, for his commission to write the history was renewed and I
am informed by Professor Edward A. Whitney of Harvard, who dis¬
covered the will of Polydore in the Archives at Urbino, that records in
the Royal Treasury indicate numerous grants to Polydore for the history
after the death of Henry VII, and that when Polydore went to Basel to
see the book through the press the English government made a grant

“ Whitney, E. A., and Cram, P. P. The will of Polydore Vergil. Proc. R. hist. Soc.,
1927, 11 (4th s.): 117-136. The will establishes the date of Vergil’s death as ISSS.

80 J. F. FULTON

which permitted him to travel with six horses and six servants. The
grant, however, did not cover his entire expense.

Polydore Vergil’s history of England stands in relation to historic^ra-
phy in much the same position as the Fabrica of Vesalius stands to
anatomy. Vergil’s historical method was far in advance of anything

produced prior to his time in England, or, for that matter, on the Conti¬
nent. While he opened himself to the accusation of personal prejudice
in dealing with certain of his contemporaries such as Wolsey, the book
is clearly a document of first importance in the development of historical
literature. The first and second editions, 1534 and 1546, both issued
from Basel, contain twenty-six books covering the period from earliest
times to 1509, the end of the reign of Henry VII. In the third folio pub¬
lished in Basel in 1555, the year of Polydore’s death, the twenty-seventh
book was added which carried the history to 1538, the year of the birth
of Edward VI. The editions of the histo^ so far traced are as follows:

List of Editions of
ANGLICA HISTORIA

Anglicae historiae Libri XXVI.

Libri XXVII

Libri XXVI

Libri XXVII

Historia anglica, ed. G. Lely
Historiae anglicae libri XXVI,
ed. A. Thysius.

Three books of English history,
ed. H. Ellis

English history, ed. H. Ellis

Basel, J. Bebel, 1534, fol. CtY. DLC, BM, OB.
F (2), CSmH

- M. Isengrin 1546, fol. ICN, BM, F,

CSmH

- 1555, fol. BM, OB, F

- 1556, fol. BM, CSmH

Ghent, C. Manilius, 1556-7. 2 v. 8® BM,
CSmH

Basel, M. Isengrin, 1557, fd. CtY, F

-T. Guarin, 1570, fol. CtY, BM, OB, F

Douai, 1603, 2 v. 8® BM

Leyden, 1649. 8® Vatican CSmH

Leyden, J. Maire, 1651, 8® ICU*, BM**, OB

London, 1844. 4® CtY, DLC, BM, F

-, 1846. 4® CtY, DLC, F

* Colophon: Lugduni Batavonun, typis Philippi de Cro-y anno 1649.

** British Museum Catalogue does not give colophon.

List of Library abbreviations — BMC British museum. Dept, of printed books.
Catalogue of printed books; CtY Yale University Library, New Haven, Con¬
necticut; DLC Library of Congress, Washington, D. C.; ICN Newberry Library,
Chicago, Illinois; ICU University of Chicago Library, Chicago, Illinois;
OB Bodleian Library, Oxford; F Library of John F. Fulton, now in the Historical
Library, Yale School of Medicine, New Haven; CSmH, Henry E. Huntington
Library, San Marino, California (donated by Prof. E. A. Whitney).

POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF PHYSICK 81

Polydore was too wise a man to include the reign of Henry VIII in
the first edition of his history. He had had a taste of Wolsey’s temper,
and in attempting to keep peace between Henry and the Papacy he no
doubt had had many an anxious moment. He discreetly dedicated his
history to the “ Invincible Henry, King of England, France and Ireland! ”
In view of the dedication and the grants from the Royal Treasury there
is every reason to believe that Polydore enjoyed the King’s confidence
and respect. Further evidence pointing in this direction comes from the
study of the dedication copy of the book recently acquired by the His¬
torical Library of the Yale School of Medicine from Thorp, the botAseller
of Guildford. It is bound sumptuously in Ro)ral Tudor calf, with the
Tudor rose, the crown, portcullis, dragon and the French fleur-de-lis in
its armorial design (Fig. 10). The original clasps are also preserved,
but not the back. The binding was evidently repaired in the nineteenth
century and the new end papers may cover traces of early provenance.
We have been able to reconstruct the story of the volume from the binding,
the bookplate (of the Rt. Hon'*'* Viscountess Scudamore) and the various
inscriptions. As already intimated the binding is clearly that of a Tudor
King, and while it does not carry the “HR” of Henry, this may have
been destroyed when it was rebacked. The armorial design on the covers
is identical with that of many other volumes known to have been in the
Royal Library during Henry VIII’s reign. The first inscription on the
title page gives some intimation of how the bocJc may have disappeared
from the Royal Library. It indicates that the bo<^ was given as a gift
sometime in the sixteenth century by John Scory, Bishop of Hereford,
to Miles Smith, Bishop of Gloucester. The inscription reads as follows

(Fig. 7):

Liber Milonis Smythi ex dono Reuer: Episcopi Heref: Joan: Scoree

John Scory was originally a Dominican friar (1530) and one of Cran-
mer’s preachers at Canterbury. He was nominated Bishop of Rochester
in 1551, and of Chichester in 1552, but Mary, on her accession to the
throne, deprived him of his See and his wife, but absolution followed. He
then left England for a time, but on Elizabeth’s accession he returned and
she later appointed him to the See of Hereford in 1559. He held the
bishopric until his death in 1585, but during his occupancy the Crown
confiscated many of the lands belonging to the See of Hereford, and it
was rumored that Scory received personal compensation for some of his
ceded lands. It is possible, but by no means proved, that Scory obtained

J. F. FULTON

this volume as a gift from the Queen,“ but it is also possible that he might
have had it from Henry himself.

Miles Smith, to whom'the volume was presented, was born in Here¬
ford, graduated from Oxford, and appointed to the Prebend of Hinton in
the Hereford See in 1580, and Canon, five years before Bishop Scory’s
death. He was an eminent classical and oriental scholar, and one of the
most distinguished of the translators of the King James version of the
Bible. He was promoted to the bishopric of Gloucester in 1612 and died
there 20 October 1624. It is interesting to note in passing that Polydore
Vergil himself held as one of his benefices the Prebend for Nonnington
in Hereford Cathedral, being appointed about 1507.**

The Scudamores of Holm Lacy were a Hereford family and the father
of the first Viscount was a contemporary of Miles Smith. We have estab¬
lished that the bookplate is not that of tl^ first or second Viscountess,
but rather of the third, since in addition to the Scudamore arms—(three
stirrups leathered and buckled) it has the fleur-de-lys argent of the Digby
family, and the third Viscountess was Frances, daughter of Simon. Lord
Digby. She died in 1729 and with her the line was extinct. There is as
yet no information about how the volume happened to pass frcwn the
Bishop of Gloucester to the Scudamore Library and thence to Thorp’s
bookshop in 1939.

Far more important are two other inscriptions, possibly in Polydore’s
own hand. The first occurs at the bottom of the title page (Figs. 8 and 9)
and the other a more detailed description on the verso of the title. Trans¬
literated they read:

(i) Carolus Henricus vivant defensor uterque
Henricus fidei Carolus Ecclesiae.

(ii) Carole qui fulges sceptro et diademata sacro
Tuque Henrice simul stemmata iuncta gerens.

Alter Germanis, alter lux clara Britannis
Miscens Hispano S 2 inguine uterque genus
Vivite foelices quot vix et secula Nestor
Vivite Cumanae tempora fatidicae

In the Cathedral Library at Hereford is a copy ol The Golden Legend printed by
Caxton. “Entirely the first edition of 1483. Suse 1354x9}4. No perfect copy has been
discovered. 36 only are known . . . The original binding, metal-work, and chain, are in
good state. The letters H R, roses, portcullises, and other patterns, are stamped on the
sides. On the outside may be still read ‘To Mr. Phillips of New Colledge, Chapleyne’.”
Havergal, F. T. Fasti Herefordenses, Edinburgh, 1859 (see p. 186).

** His kinsman, Adrian de Castello, an Italian Cardinal, was consecrated Bishop of
Hereford in 1502 on appointment of Henry VIII, translated to Bath and Wells in 1504,
but never saw these dioceses. He was deprived of his preferments in 1516, for conspiring
against the Pope. Havergal, p. 26.

PALMA

An enlarged detail of Bishop Scory’s (Sconce) inscription of Polydore's Anylica historia
to Miles Smith (For wording of inscription see text).

POLYDORI VERGILII

TRIINATIS ANGLICAE HISTO
RIAE LIBRI XXVL

Title-page of the first edition of Polydore Vergil’s Aui/lirac liisloriac Libri XXVI.
Presentation copy to Henry VIII with Polydorc’s inscription and
monogram at the bottom.

8 -

iMdicef rvntm fmguUrmcopiofot CTifd
cgrcgio fiuuroftadiecmiu.

Cum gratia ^ priuilegio Cscfarco.

Fig. 10.

Binding of tlie front cover of royal dedication copy of Polydore X'ergil’s history of England.
Note the Tudor rose, crown, portcullis, dragon and fleur-de-lys.

POLYDORE VERGIL, HIS CHAPTERS ON THE HISTORY OF PHYSICK 87

The reference on the first inscription to Henry “ as defender of the faith ”
and Charles “ defender of the Church ” suggest that Polydore had diplo¬
matic talents. His talents in this direction are even more evident in the
second dedication. I am indebted to Dr. W. W. Francis for the following
rendering:

Charles [V] refulgent with the Holy [Roman] scepter and diadem
And thou, Henry, bearing joint [heraldic] arms [with him].

One the famous light of the Germans, the other of the English,

Both mingling your ancestry with Spanish blood.

Live happily as many years [ages] as Nestor,

Live as long as [the times of] the prophetic Cumanean [Sybil].

In identifying these inscriptions the question has been raised whether
they were actually in Polydore’s hand. Professor Castiglioni pointed out
that the flourishes at the right of the inscription on the title probably
represent a somewhat over-embellished P V. The small monogram made
up of an elided R and L [ jt ] may stand for Rector Langtonis, since
Polydore’s first official position was “ Rector of Church Langton, Leices¬
tershire.” The same monogram occurs at the end of the longer inscription
and the flourishes here somewhat more restrained, can also be taken for a
P and V and the R L and the cross are repeated. Professor Whitney
has pointed out that humanist script of this period is extremely difficult
to identify, owing to the close similarity between many scholars, but in
view of the royal binding, the dedication itself, the sense of the inscrip¬
tion, and the fact that there is no evidence to the contrary, I have been
led to believe that it is, in fact, the dedication copy to Henry VIII and
that the inscriptions are in the hand of Polydore himself.^* The book and
the inscriptions add an interesting side-light on the relations existing
in 1534 between Henry VHI, Charles V and the Holy Roman Empire.

Polydore Vergil may thus be set down as one of the great humanist
scholars of the Renaissance. His stature as a general historian has
increased with the years, but only during the last generation has he been
praised in just perspective, this having come about largely from the
studies of Gasquet,“ Whitney, and more recently from J. Westfall Thomp¬
son’s great treatise A History of historical writing (1942). Vergil can
also lay claim to an important place as an historian of medicine and tech-

**Botfield {Notes oh the cathedral libraries of England, London, 1849, p. 185) lists:
Polydore Vergil, Historia Anglicana, at Hereford; he does not include the date.

’* Gasquet, F. A. Some materials for a new edition of Polydore Vergil’s “ History.”
Trans. R. hist. Soc., 1902, i6 (2ds.) : 1-17.

J. F. FULTON

nology. This was first fully appreciated by John Ferguson, and will be
further emphasized when the many editions of De inventoribus rerum
receive final analysis.

From the vigorous blood of Castellan has come many men whose influ¬
ence has far transcended the continent of Europe. When the Castellans
came to settle in Italy longer than had Polydore, many became known,
not as the Castello, but rather as Castiglioni.

JEAN ANTOINE FRANgOIS OZANAM
1773-1837

SOLDIER, PHYSICIAN, EPIDEMIOLOGIST
Follower of Hippocrates and Sydenham
in the development of the concept of the
Epidemic Constitution

lAGO GALDSTON

Who was it, Dear Arturo, invented the Festschrift? It is a most civil
custom, and for those born or bred in the Anglo-Saxon tradition, a great
convenience. It affords a license for the public show of affection which
otherwise might not be in “ good taste.” It also is a flattering practice;
flattering to those who like myself can, at the cost of some modest labor,
link their names (at least in the library catalogue) to some luminary,
great in years and achievement.

It is with real pleasure, then, that I join with so illustrious a group to
salute you on this, your seventieth year. I wish you your heart’s wish of
years. May your powers remain undiminished.

It was a cruel fate that drove you from your beloved home and brought
you to our land. But I must confess, I draw some purely selfish satisfac¬
tion from the events. For otherwise, such as I, who am in great measure
landlocked, might never have come to know you, as now I do. You would
have remained a “ mysterium,” only a name appended to works of out¬
standing merit. Now I know the man as well as his works and can better
prize the one for the other. I must confess I am partial to the man. His
gay spirit, the eloquence that animates the whole of his generous frame
(and can convey meaning as well as enthusiasm, even in the English
idiom), his catholic intelligence, his broad sympathies, his tolerance for
the foibles of his fellow men, his relish for all things good, his Latin
courtesy, and his fortitude, single him out to be cherished and loved. And
so indeed we do, many others and I, as witnessed by these pages. But
decorum nudges me on the shoulder. I must not go on in this vein.

To this Festschrift, Dear Arturo, I bring not only the attestation of
my affection, but also a small tribute. I had hoped it might be a garland,
but alas it is only a sprig. You know however the reason for my p)overty,
and I shall not offer any excuses. Yet I know you will receive this tribute
generously, and I fancy you may even like it, for it concerns a man whose

I AGO GALDSTON

j ilk you favor, having yourself redeemed many like him from ill-deserved

obscurity. I offer you some notices on the life and works of Jean Antoine
Francois Ozanam (1773-1837).

But first a word as to how I came upon him. He is not mentioned in
i the “ standard ” histories of medicine, not even in yours. I came upon him

I while working on the subject of the epidemic constitution. At that time,

I while hunting among the stacks of our Academy Library, my eyes fell

upon Ozanam’s five-volume Histoire medicale generate et particuliere des
maladies epidemiques, contagieuses et epizootiques. I was puzzled. Five
volumes constitute no small work: nothing easily composed, nor easily
overlooked! Yet, though I had culled the literature on epidemics fairly
thoroughly, I had found no mention of Ozanam, not even in the writ¬
ings of Major Greenwood, F. G. Crookshank, or Sir William Hamer
who, as I believe you will agree, are by far the best contemporary students
of the subject.

Naturally, I took up Ozanam’s works and sampled them. They proved
hard reading, for reasons I’ll describe later. But at the very beginning
of his work, in the section dealing with the nature and qualities of the
epidemic constitution, I found a number of very astute observations which,
it seems to me, entitle Ozanam to a place in the history of epidemiology,
on a par with Sydenham.^ I took from Ozanam’s works so much as I had
need then. But the man continued to interest me, and in the intervening
time I have tried to learn more about his life and his works. I have tried,
too, to understand why he has been overlooked. I think I now know the
reason.

I have been, to date, more successful in learning about Ozanam’s life
than about his works. The man had the good fortune “ to be famed alike
for his fathers and for his sons.” But his works, save the Histoire, are
not to be had in our own library, nor in the Army Medical Library or the
Library of Congress.

J. A. F. Ozanam had a most interesting and busy life. He was born on
July 19, 1773, at Chalamont near Bourg-en-Bresse. He was the first
and only surviving child of his parents, Benoit and filizabeth Baudin
Ozanam. The father, Benoit, was a notary and Director of the Dombes.
The mother was a descendant of Jean de Saillans, ennobled by Louis XII.

The Ozanam family had been noteworthy for many decades before the

* The substance of Ozanam’s observations and the reasons why I value them so highly,
I expounded in the article, “ The Epidemic Constitution in Historic Perspective,” Bulletin
of the New York Academy of Medicine, September, 1942, second series, Vol. 18, No. 9,
pp. 606-619.

JEAN ANTOINE FRANCOIS OZANAM 1773-1837

advent of Jean Antoine. There is a quaint story fostered by Catholic
writers which traces the family back to the seventh century. The tradition
runs * that the family whose name is said to derive from Hosanna, or its
plural Hosannam, descended from a kindly French Jew, Samuel Hosanna.
Samuel gave refuge to St. Didier when the latter was persecuted by Queen
Brunhaut whose wicked manner of life he had denounced. As a reward
for his mercy, St. Didier baptized Samuel and his people “ in the true
faith.”

The eminence of the Ozanam family, however, rests more securely on
the achievements of its later members. ” The Ozanams,” as another
Catholic writer describes them, ” would seem to be one of those races
where virtue and science are an entailed inheritance, descending like heir¬
looms from one generation to another. For more than three centuries,
every generation produced some distinguished man of science, and inva¬
riably counted one, frequently several, members in the service of the
sanctuary.” *

The first among the Ozanams to attain eminence was Jacques (1640-
1717), the granduncle of Jean Antoine, and the “Patriarch” of the
family. He was a mathematician, and the author of many works, among
which the best known is Recreations in Mathematics and Natural Philoso¬
phy. This work was republished in many editions, was revised and
enlarged by the noted mathematician, Jean Etienne Montucla (1725-
1799), and was in 1803 translated into English by Charles Hutton,
LL. D.. Professor of Mathematics in the Royal Academy at Woolwich.

Jacques Ozanam was “ intended for the church ” and accordingly spent
four years in theological studies. However, on the death of his father,
he abandoned theology and devoted himself to mathematics and science.
He appears to have been a gay, lively person, addicted to gaming and
expensive habits. Having been called to Paris by the Chancellor of France,
Jacques spent some time in dissipation, then married “ a young woman
without fortune, but who proved to him a most excellent wife. After
bearing him twelve children, all of whom died young, she died in 1701,
deeply lamented by her husband.” * It is reported of him that “ He was

’J. F. Brodrick, S. J., Frederic Ozanam and His Society, 1833-1933 (London, Bums,
Oates and Washboume, Ltd., 1933), pp. 1-3.

* Kathleen O’Meara, Frederic Ozanam, Professor at the Sorbonne, His Life and
Works (Catholic Publication Society, New York), 1st ed., 1878, p. 1.

‘Jacques Ozanam, Recreations in Science and Natural Philosophy, Dr. Hutton’s
Translation of Montucla’s Edition of Ozanam. New Edition, revised and corrected, with
numerous additions, by Edward Riddle (London, 1854), p. vi.

lAGO GALDSTON

of a mild and cheerful temper, generous to the full extent of his means, and
of an inventive genius; and his conduct after marriage was irreproachable.
He was devout, but averse to disputations about points of faith. On this
subject he used to say, ‘ It is the business of the Sorbonne to discuss, (rf
the Pope to decide, and of a mathematician to go straight to heaven in a
perpendicular line' " ®

The second noteworthy member of the Ozanam family was Jean
Antoine, the grandnephew of Jacques Ozanam, the mathematician, and
the subject of this study. Then, to complete our enumeration of the Oza¬
nam galaxy, there remain to be noted two of the sons of Jean Antoine,
namely Frederic Ozanam, who founded the Society of St. Vincent de
Paul in 1833, and Charles Ozanam who was a physician in Paris.*

There is much more that could be told about the Ozanam family, which
was indeed remarkable for the number of able men it contributed to
society. But such an excursion would take us far afield. We must return
then to Jean Antoine, the physician and epidemiologist.

Jean Antoine began his formal education at the age of eleven, having
been previously tutored at home. He attended the College de Bourg from
1784 to 1790. Completing his studies there, he attended for one year the
Seminaire de Saint-Irenee, an agrege of the University of Valence.
Here, he studied philosophy. Then, having attained to the age of eighteen,
Jean Antoine was placed with M. Populus, one of the family relations who
was the receveur de I’enregistrement at Bourg. After a year of appreti-
ticeship Jean Antoine was named receveur at Pont d’Ain. He could not,
however, fill this post, for he was shortly conscripted in the army of the
Revolution.

Jean Antoine spent the next six years in military service. He partici¬
pated in most of the major battles in the Italian campaign. He fought at
Mondovi, Fombio, Lodi, Pavie, Mincio, Castiglione, Roverno, Bassano,
Saint Georges, Arcole, Rivoli, De la Favorite, and Tagliamento. He had
a charmed life, for though wounded thrice he ended his military career
sound in body and health. At the battle of Mincio, Jean Antoine’s Colonel
was killed at his side. Here, Jean Antoine captured and made prisoner

‘Jacques Ozanam, op. cit., p. vi.

* Hermann Vierordt, in his Geschichte der Herskrankheiten refers several times to the
work of Charles Ozanam entitled, La circulation et le pouls, histoire, physiologic, semeis-
tique, indications, therapeutiques, Paris, j886; Max Neuburger and Julius Pagel, Hand-
buch dcr Geschichte der Medisin, Vol. II (Jena, 1903), p. 629. The Army Medical
Library catalogue lists many works by Charles Ozanam, published between 1840 and
1850, dealing with children’s diseases, eclampsia, jaundice, etc.

JEAN ANTOINE FRANgOIS OZANAM 1773-1837

the General Major of the Neapolitan Cavalry. At Castiglione, Jean
Antoine was wounded in the left wrist, and in the battle of Roveredo he
was struck on the head by a musket ball which fortunately only inflicted a
flesh wound. He was wounded again at Tagliamento. In this battle he
captured a standard of the Krasinsky Uhlans and presented it to Bona¬
parte. The General promised to “ remember the brave officer,” but his
memory proved short.

There is one incident which occurred during Jean Antoine’s military
life worth noting, since it mirrors the high spirits of the man. Shortly
after Jean Antoine had entered the army, his regiment was ordered to
march from Bourg, where it was stationed, to Vienna. The route brought
him near to Chalamont where his parents lived. He took time off to visit
them, but on arriving at Chalamont he discovered that his father had been
arrested and imprisoned at D’Ambronay. The local vigilance committee,
by whose orders the old Benoit had been arrested and imprisoned, was
meeting on the very day of his visit. Jean Antoine decided to right things
forthwith. With two hussars to aid him, he descended on the Committee
and compelled them, at pistol’s point, to free his father. This hot-headed
heroism, however, availed little, for the Committee, recovering from its
fright, countermanded its order, and Benoit, lucky not to have lost his
head, remained a prisoner for eleven months. He was released in the
general amnesty that followed on the death of Robespierre.

In 1799 Jean Antoine solicited and with much difficulty obtained his
release from the army. Weary of war, and now twenty-six years of age,
he went to Lyon, hoping there to establish himself as a merchant. He
married Marie Nantas in 1800, and for a number of years devoted himself
to the affairs of the silk merchant. Apparently Jean Antoine was not
gifted in business, for his affairs did not prosper either at Lyon or at
Milan, to which city he removed. But at Milan the aspirations of his
youth were revived, and by a play of fortune were fostered by his towns¬
man, and well-known surgeon, Marc-Antoine Petit of Lyon.

' Jean Antoine, when young, had aspired to be a physician. His father,
however, wanted him to follow the law. He had gained the first legal
1 mng when he was appointed receveur at Pont d’Ain. But conscription

I had blocked all further advance. Now Jean Antoine’s father was dead.

(He had died in 1800.) Parental obligations no longer compelling, he
turned his thoughts to medicine. He was encouraged and helped by Marc-
Antoine Petit, who chanced to be in Milan, having been called there to
operate on a cataract. Petit recommended Jean Antoine Ozanam to sev-

I AGO GALDSTON

eral of the professors at the University of Pavia, among them the bril¬
liant teacher, surgeon, anatomist and illustrator, Antonio Scarpa. Jean
Antoine undertook the study of medicine, pursued it with devotion, and
in 1810 passed his examination at Pavia “ a pieni voti e con laude.” He
was now thirty-seven years of age. He devoted the remainder of his life
to the practice of medicine, and to writing. He was eminently successful
in both.

Ozanam began the practice of medicine at Milan, but being unhappy
with the Austrian rule that then fettered Lombardy, he removed, in 1816,
to Lyon, the capita) of his native province. There, he remained until his
death on May 12, 1837. Within a year after he settled in Lyon, Jean
Antoine, following a brilliant concours, was named physician of the Hotel-
Dieu. He soon acquired an extensive practice, and devoted much of his
time to the service of the poor. He was, judging by his history, as well
as by the volume and quality of his writings, an indefatigable worker.
He must have been a voracious reader and a good linguist. Despite his
devotion to his professional duties, he found time and strength to be also
a devoted father and husband. He had fourteen children, only three of
whom survived. One very gifted daughter died at the age of eighteen, oi
meningitis. His sons speak of their father in the fondest terms of affec¬
tion. “ He loved his old poets dearly and nothing gave him greater pleas¬
ure than, in spare moments, to con Virgil or Horace with his three boys
while their mother knitted by the fire.” ’’

The biobibliography of Ozanam contains fourteen items which, listed
in the order of their publication, are as follows:

1. De I’influence des maladies organiques des visceres du bas-ventre sur ceux de

la tete et de la poitrine (work composed for the Society of Medicine of

Lyon), 1811.

2. Des maladies chroniques qui influent specialement sur la poitrine (Memoire

presente a la Soc. de m^ecine de Montpellier, 1812).

3. Demiere campagne de I’armee franco-italienne sous les ordres du Prince

Eugene Beauhamais en 1813 et en 1814. Lyon, 1817, in-8°.

4. Conseils aux bonnes meres sur la grossesse, les couches, I’allaitement et

I’epoque critique, et sur les maladies des enfants. Lyon, 1817, in-8°.

5. Histoire medicale, generale et particuliere, des maladies epidemiques, con-

tagieuses et epizootiques, qui ont regne en Europe, depuis les temps les plus

recules, et notamment depuis le XIV* siecle jusqu’a nos jours. Lyon, 1817-

1823, 5 vol. in-8°; Paris, 1835, 4 vol. in-8®.

6. Sur la nature des emanations insalubres qui s’exhalent des marais (Mdm.

presente a I’Acad. des sc. de Lyon, 1823).

’J. F. Brodrick, op. cit., p. 5.

JEAN ANTOINE FRANCOIS OZANAM 1773-1837 95

7. Sur Taction des emanations marecag^euses sur Teconomie aninude (Mem.

present^ a TAcad. des sc. de Lyon, 1824).

8. Memoire sur le d^reusagre des soies sans acide ni alcali (M6m. presente k

I’Acad. des sc. de Lyon, 1825).

9. Mem. statistique pour servir a Thistoire de Tetablissement du christianisme a

Lyon, depuis le II* siecle de TEglise jusqu’a nos jours, 1829.
lOi Sur Tutilite des machines (Mem. presente a la Soc. pour Tinstruction ele-
mentaire, 1830).

11. Reflexions sur la doctrine de Saint-Simon. Lyon, 1831, in-8°.

12. Conseils sur les moyens de se garantir du cholera, et sur les premiers soins a

donner a ceux, qui en sont attaques. Lyon, 1832, in-8“.

13. Statistique de Lyon et du dipartement du Rhone, depuis le I*', octobre 1823

jusqu’au 31 decembre 1833 (Mem. presente a TAcad. des sc. de Lyon, 1832).

14. Compte rendu du service medical et des observations faites au gp’and Hotel-

Dieu de Lyon, depuis le 1*^ octobre 1823 jusqu’au 31 decembre 1833. Lyon,
1834, in-8°.

It will be observed that a number of Ozanam’s writings dealt with
social, economic, and industrial subjects. One of them was devoted to
a history of his establishment of Christianity in Lyon. Of Ozanam’s medi¬
cal writings, two appear to have been of a popular or lay character. One
is a work of instructions to midwives, including a section on the diseases
of infants. The other is a work on cholera, including “ prophylaxis,” early
symptoms, and first aid.

I have not been able to locate any of Ozanam’s works other than his
Histoire medicale, generale, et particulilre des maladies epidSmiques,
contagieuses et epizootiques. I do not, however, feel particularly handi¬
capped because of this. The Histoire is an omnibus work into which
Ozanam wrote not only all that he had learned from the study of the works
of others but also what he had learned and observed in his own experience.
The second edition of the Histoire, from which I have drawn most of
my references, was published in Paris, in 1835, two years before its
author’s death. Since the second edition had been thoroughly revised and
amplified by Ozanam, I feel warranted in assuming that it contains the
ideas and beliefs which he had incorporated in his other medical works.

We are told by his son, Charles, that Ozanam worked ten years on the
composition of the Histoire. The evidence of much reading, much work,
and good thinking is witnessed in this work. The first edition, published
in Lyon, consists of five octavo volumes which were issued between 1817
and 1823. The volumes contain a total of close to two thousand pages.
The second edition, which appeared twelve years later, consisted of four
octavo volumes. In this edition the work was considerably augmented.

lAGO GALDSTON

but was printed in smaller type and on a somewhat larger type page. A
German translation of the first edition, made by H. Brandeis, appeared
in 1820.®

The aim and order of the Histoire were, in the author’s own terms, to
ascertain and to give the chronologic history of each type of malady from
the time of the first knowu appearance in Europe; to list and describe for
every disease those general and particular symptoms upon which there
was common agreement among the authors consulted, and as witnessed
in different countries (Germany, France, England, and Italy), and during
many centuries; to describe the common progress of each disorder and its
complications; to detail the most successful methods employed in the
treatment of each disease, including the empirical poly-pharmacy
employed, and to give aphoristically the prognosis of each disease.®

The order followed in the Histoire was not unlike that of the modem
medical text book, save only that Ozanam limited his study to those dis¬
eases which he termed epidemic and contagious. “ Je resolus,” he wrote,
“ de bomer mes recherches aux maladies epidemiques et contagieuses,
qui sont celles qui affligent le plus communement et d’une maniere plus
generale la creature vivante, et qui constituent la majeure partie des
maladies aigues, et meme quelques-unes chroniques.”

Yet Ozanam did not intend merely to write a medical text book. His
aim was more ambitious than that. It was to acquire by attentive obser¬
vation of all that bears on the origin, course, and treatment of disease,
such perfect certitude in the arts of medicine as would enable the physician
not only to diagnose promptly and to treat effectively, but also to antici¬
pate and to prevent disease.*^

His method in achieving his objective involved two procedures, one
nosographic, the other epidemiological. In all this it can be seen that
Ozanam was a faithful disciple of Sydenham. Ozanam indeed had an
unbounded admiration for the English Hippocrates, and quoted him
frequently and approvingly. Ozanam was, I believe, the first to treat
epidemiology nosographically, grouping the disorders considered, under
six general headings: the Epidemies propres, Epidemico-contagieuses.
Contagieuses, Indeterminees, Particulieres et inconnues, and Epizooties.

Of nosography, Ozanam wrote:

* H. Brandeis, 1820. Allgem. u. besond. Geschichte d. epid. Krankheiten, 1820. Stutt.
u. Tiibing., 1820.

•J. A. F. Ozanam, Histoire Medicale Generale et Particuliire des Maladies £pi-
dimiques, Contagieuses et Ppisootiques, 1st ed., 1817, Vol. I, pp. xiii-xiv.

“ Op. cit., p. vi.

Op. cit., p. V.

JEAN ANTOINE FRANgOIS OZANAM 1773-1837 97

Je suis convaincu que cette methode est la meilleure pour conduire le medecin
a la connaissance la plus exacte des maladies, connaissance fondee sur I’observation
et Texperience de plusieurs sidles. Et certes, si en etablissant les caracteres, la
marche et le traitement d’une maladie, sur un grand nombre d’observations faites
par les praticiens les plus instruits et les plus celebres, on ne peut en fixer la doc¬
trine d’une maniere sure et precise, alors il ne faut pas esperer de jamais donner a
la science medicale une direction ferme, eclairee et invariable.^*

The descriptive nosology Ozanam supplemented with an extensive and
all-embracing consideration of etiologies. This is his epidemiology proper,
the major portion of which is devoted to the epidemic constitution. In
this, too, Ozanam follows Sydenham, but he advanced far beyond his
English predecessor.

Ozanam had studied carefully, not only the works of Sydenham, but
also those of the best among the writers on epidemiology. Describing his
labor, Ozanam wrote: “ J’ai du compulser plus de huit cents ^rits Latins,
Allemands, Anglais, Fran^ais, Italiens et Espagnols, ainsi qu’on le verra
dans la bibliographie que j’en donnerai a la fin de I’ouvrage. Un grand
nombre de savans medecins fran^ais et etrangers ont bien voulu me com-
muniquer leurs observations particulieres. J’ai puise des documens impor-
tans dans plusieurs riches bibliotheques d’ltalie, et sur-tout a Pavie et a
Milan ou j’ai eu a ma disposition celle de Haller, qui m’a considerable-
ment facilite dans mon travail, par la quantite d’auteurs anciens et mod-
ernes, de memoires et de manuscrits interessans que j’y ai trouves, et qui
m’ont ete communiques avec la complaisance la plus affable par les.direc-
teurs de ces etablissemens magnifiques.” **

The significant portion of Ozanam’s contribution to epidemiology lies
in his conception of the epidemic constitution, which he distinguishes, as
did also Sydenham, from the epidemic proper. In this distinction, and in
the recognition of the qualities and nature of the epidemic constitution,
reside the warrant for placing the name of Ozanam beside that of Syden¬
ham, high in the history of epidemiology. What Sydenham sensed
obscurely, Ozanam saw clearly. Where Sydenham mumbled, Ozanam
spoke distinctly.

The concept of the epidemic constitution is of Hippocratic origin.
" Hippocrate, en creant I’etude des constitutions epidemiques, a merite
notre admiration et notre reconnaissance eternelles; mais il a laisse de
grandes lacunes a remplir.”

Op. cit., p. xiv.

** Op. cit., pp. x-xi.

Op. cit., p. 10.

lAGO GALDSTON

Many among the ancient, and also among the more recent medical
authors, sought by diligent study and by broad and meticulous observa¬
tions, to fill the lacunae of the Hippocratic concept. Their labors, how¬
ever, only served to compound confusion. Most of them attempted to
discover the epidemic constitution of the particular epidemic which they
studied. Sydenham was first to depart from this and to distinguish
between particular epidemics and the epidemic constitution. He advanced
the theory that particular epidemics were engrafts upon the epidemic
constitution; that the epidemic constitution was, in other words, a generic
factor common to all species of epidemic disease.

Sydenham’s thoughts had little influence upon those who came after
him. Only Ozanam absorbed them completely and advanced them further.
He firmly grasped the distinction and the significance of the epidemic
constitution and restated them with Gallic clarity.

In distinguishing between the epidemic and the epidemic constitution,
he wrote:

Une constitution epidemique est un espace de temps indetermine, durant lequei
regnent des maladies qui, quoique d’un caractere different en apparence, n’en ont
pas moins toutes la meme origine et la meme diathese. C’est une maladie unique,
dont les formes variees ne sont, pour ainsi dire, que des s)rmpt6mes, et qui n’exige
qu’une seule methode generale de traitement . . .

La propriete principale de la constitution epidemique, est done d’attaquer
I’homme sous differentes formes, et souvent sous des formes insidieuses, selon I’age,
le sexe, le temperament et les dispositions physiques de chaque individu.

L’epidemie proprement dite se montre toujours sous la forme qui doit la carac-
teriser, et elle attaque Thomme d’une maniere uniforme . . .

Une constitution epidemique stationnaire prolonge quelquefois sa dur^e i plu-
sieurs annees . . . , [while,] L’epidemie eventuelle n’a au contraire qu’une dur^
limitM, mais indeterminee ...”

La constitution epidemique a une influence plus generale sur I’espece humaine;
mais son action ne se fait sentir que d’une maniere irregidiere et diversifiee, ce qui
produit la variete des maladies qui en derivent; au lieu que I’epidemie a la sienne
plus directe, plus uniforme et plus marquee sur les individus qu’elle attaque, et cette
action n’est point latente ou masquee comme dans la premiere.

Telles sont les differences qui distinguent le caractere des constitutions epi-
demiques et de I’epidemie proprement dite; elles sont assez marquees, pour qu’il
ne soit plus permis de les confondre.^’

These sentences encompass a wealth of knowledge and witness a pene¬
trating insight into the core-problem of epidemiology.

Practically all epidemiologists, both of the pre- and of the post-Pasteurian

“J. A. F. Ozanam, Histoxre Medicate Generale et Particuliire des Maladies £pi-
dimiques, Contagienses et Ppisootiques, 2nd ed., 1835, Vol. I, pp. 38-40.

JEAN ANTOINE FRANgOIS OZANAM 1773-1837

period, have been exclusively concerned with the specific causes of specific
epidemics. None, save Hippocrates, Sydenham, Ozanam, and a small
group of modern (mostly English) epidemiologists, has conceived of the
existence of, or been concerned with, the generic causes of epidemics con¬
sidered as a collective phenomenon. The core-problem of epidemiology is
not what caused this epidemic or that epidemic, but rather, what makes it
possible for epidemics to prevail among peoples. Major Greenwood thus
aptly phrased the issue of such considerations: “ We are led to ask whether
what is wrong with the unhealthy may be not infection with this or that
germ, but unhealthiness, even as the chief trouble of the poor is not addic¬
tion to public houses, but just plain poverty.”

It is not possible to elaborate here the important bearing which the con¬
cept of the epidemic constitution has upon present-day medicine and pres¬
ent-day epidemiology. It must suffice merely to affirm that the matter is
grossly neglected, to the grievous disadvantage of medicine and the
public, but that Ozanam had grasped and had expounded it clearly.

It is noteworthy, too, that Ozanam was among the first to study the
epidemiology of mass-psychopathies. ” Les passions de Tame,” he wrote,
“ ont quelquefois donne lieu a des epidemies convulsives ou de demence,
qui se propagent par imitation. L’histoire ancienne et moderne en fournit
plusieurs exemples.”

In his Histoire he deals with a number of mass psychopathies under the
headings: “Danse de St-Gui, Convulsions,” “Alienation Mentale,”
“ Lycanthropie,” “ Incube,” “ Fureur Uterine,” “ Epilepsie.”

There remains one problem to be resolved. Why is it that Ozanam has
found no place befitting his merits in the chronicles of medical history?
The reason seems plain. He came and worked in the dawning years of
bacteriology. His light was paled by the brilliance of the new era which,
even as Ozanam was composing his work, was already illuminating broad
sectors of the medical horizon. Only five years intervene between the
publication of the second edition of Ozanam’s Histoire Midicale, “ con-
siderablement augmentee,” and that of Jacob Henle’s essay “ On Miasms
and Contagia.” For all his study and work, and despite his brilliance and
originality, Ozanam could not appreciate the promise of bacteriology. He
knew and fully understood contagion, but not the contagium animatum.
“ Nous reconnaissons et nous admettons qu’il existe des maladies epi-

**Major Greenwood: Sydenham as an epidemiologist, Proc. Roy. Soo. Med., London,
1919, Epidem. Sect., Vol. XII, parts I and II.

" Ozanam, Histoire Midicale, 1st ed., 1817, Vol. I, p. 33.

100

lAGO GALDSTON

demico-infectieuses,” he wrote. But he denied the validity of the theory
of “ I’animalisation des contages.” On this score he wrote: “ Nous con-
naissons un grand nombre d’auteurs qui ont ecrit sur Tanimalisation des
contages. Plusieurs ont avance que leurs principes, non-seulement ema-
nent de la substance animale, mais meme qu’ils sont organiques et animes.
Varron, Columelle, Lucrece, le pere Kircher, Lancisi, Vallisnieri, Reau¬
mur, Christ, Lang, Plenciz, Menuret, Rasori et quelques autres, ont
embrasse cette opinion. Fremont a pretendu que les contages naissaient
et se developpaient dans les corps par la fermentation; nous ne perdrons
pas de temps a confuter ces hypotheses absurdes.”

In his very brief biographical notice on Ozanam, Pagel wrote: “ Sein
bekanntestes Werk ist die wegen ihrer Fliichtigkeit fast unbrauchbare.”
This judgment is too harsh. It is true, however, that Ozanam’s work is
of uneven worth. It is a mosaic in which bright insight and clear under¬
standing are spotted with ignorance and misconceptions. Yet the matrix
is good, and the total effect sound.

His blunders were no greater than those later committed by the bac¬
teriologists. If he missed the specific, he saw clearly the broad genetic
factors in epidemiology. He appreciated the epidemic constitution, though
he could not define it in all its multiform elements. He knew full well its
bearing upon the prevalence of epidemic diseases among people. But that
which he knew and taught was overcast by the great discoveries in bac¬
teriology. These discoveries appeared to an enthusiastic and uncritical
world to be the final and definitive answer to the riddle of epidemic dis¬
eases. “ It is true,” as Greenwood wrote, ” that some of the leaders of
the victorious bacteriological army, including Koch himself, warned us
that the discovery of parasites and the elucidation of their life histories
left much of the mechanism of herd illness unexplained, but some of the
commissioned officers and all the camp followers of the army would know
nothing of this caution. It came to be believed, is still believed by a
majority, that epidemiology, from the scientific point of view, is a mere
appendix of bacteriology; that when the means of infection and the vehicles
of infection have been identified, the problem of an outbreak of herd sick¬
ness is solved. All the ideas of the ancients were dismissed as archaeo¬
logical lumber. . . . ” They still are so dismissed.

Because we are not used to their vernacular, we find the speech of the

** Ozanam, Histoire Medicate, 2nd ed., 1835, Vol. 3, p. 6.

” Op. cit., Vol. 1, p. 57.

** Major Greenwood, Epidemiology Historical and Experimental (Herter Lectures for
1931—^Johns Hopkins Press, Baltimore, 1932).

JEAN ANTOINE FRANgOIS OZANAM 1773-1837

101

older masters unintelligible. We are, therefore, inclined to pass up their
thoughts and their writings with a decorous nod of hommage to “ the
great but dead.” Fully aware of what the elders did not know, we trouble
little to ascertain what they did know, and seldom are stirred by the suspi¬
cion that there may be anything in that ancient knowledge of use and
value to us. Time, however, will right that.

Though Ozanam has been forgotten and neglected, he was not without
honor during his lifetime.

In 1811 he won a gold medal for his paper “ De I’influence des maladies
organiques des visceres du bas-ventre sur ceux de la tete et de la poitrine ”
presented at the Society of Medicine of Lyon. The next year (1812) he
won a prize for his paper “ Des maladies chroniques qui influent speciale-
ment sur la poitrine,” presented at the Society of Medicine of Montpellier.

In recognition of his services at the Hospital of Milan to wounded
veterans of the Russian campaign. Prince Eugene Beauhamais, vice-roi
of Italy, on April 8, 1814, decorated him with the Order of the Crown.

In 1819 Ozanam competed for the Chair of Professor of Matiire
medicale in the ecole secondaire de medecine in Lyon. He did brilliantly
but was named Professeur Suppleant. He would not, however, accept a
secondary position and immediately resigned.

In 1823 and 1824 he obtained honorable mention for two memoirs
presented at the Academie Royale des Sciences de Lyon. In 1825 he
received a gold medal worth 300 francs from the Academie Royale des
Sciences de Lyon, for a memoir entitled ” Le D&reusage des soies sans
acide ni alcali.” In 1829 he wrote ” Memoire statistique pour servir a
I’histoire de I’etablissement du christianisme a Lyon, depuis le II* siwle
de I’Eglise jusqu’a nos jours” and for this he received honorable men¬
tion from the Academy of Lyon. In 1830 the Society for Elementary
Instruction gave him honorable mention for the memoir ” Sur Tutilite
des machines.” The Academie Royale des Sciences, Belles-Lettres et
Arts de Lyon, in 1832, gave him a 300 franc gold medal for his “ Statis¬
tique de Lyon et du departement du Rhone, depuis le 1" octobre 1823
jusqu’au 31 d^embre 1833.”

In 1812 Ozanam received the diploma of Asscx:iate Member of the
Society of Medicine of Lyon. He became Titular Member in 1829. In
1828 he became associated with the Society of Mineralogy of Jena and
was named Corresponding Member of the Society of Medical and Natural
Sciences of Brussels. In 1829 he became Corresponding Member of
the Academy of Sciences and Belle-Lettres dite de buon gusto of Palermo.

102

lAGO GALDSTON

In 1833 he became Corresponding Member of the Polytechnical Society
of Paris.

Ozanam loved his family dearly. He gave his children an excellent edu¬
cation. His principal distraction was to take walks with them. He was
gay; fond of anecdotes, which he told well. He was sincerely and deeply
religious. For 15 years he served without pay as doctor of the Parish of
St. Pierre of Lyon.

Ozanam died on May 12, 1837, at the age of 64. His death was the
result of a fall.

Were Ozanam to come to life this day, and were he confronted with
the words that follow, he might, for a time at least, find them difficult to
grasp. In substance, however, they give the quintessence of his teachings.
The dynamic import of the epidemic constitution is this—To the extent
that medicine fails directly and indirectly to ameliorate the interrelation¬
ships of man and his life’s realm, it can succeed only in deferring mor¬
tality but not in decreasing morbidity, and it may be taken as a corollary
that to the extent that mortality is deferred, and life prolonged, to that
extent is morbidity multiplied and increased.

ANGINA INFLAMMATORIA(DIPHTHERIA?) AS DESCRIBED

IN DAVID ORME’S EDINBURGH DISSERTATION
(1749) AND BENJAMIN MORRIS’ LEYDEN
DISSERTATION (1750)

EDWARD B. KRUMBHAAR akd W. B. McDANIEL, 2d

Among the lesser advantages inherent in the medical dissertation—an
institution which, despite its defects, certainly possessed merit—is that of
enabling the historian to assay the effect of medical teaching on the
graduates of the various schools, as well as the relationship obtaining
between the academic teaching and the medical knowledge generally avail¬
able at the time. From manuscript and printed lectures, and by other
means, it is possible to arrive at some estimate of the subject matter and
manner of presentation of the lectures dispensed in the various schools.
But the subtle emphasis and the immediate effect of the teaching—which
determine the after influence it is to have—can perhaps best be gauged by
the dissertation, which, in principle at least, publishes the intellectual
professions of the school and the intellectual capacity of the student. It
seems regrettable, therefore, that the medical dissertations have not more
often been resorted to in studies of the development of organized medical
teaching.

Known since classical times, the disease that we now call diphtheria had
been described under various names, and more or less imperfectly, by a
number writers; especially were descriptions common when the disease
reached epidemic proportions. It so happens that two such epidemics
occurred in England, one shortly before and one shortly after the appear¬
ance of the two dissertations that we present; manifestations of the viru¬
lent forms were evidently common in England during the 18th century,
however. The two epidemics were described, respectively, by John Fother-
gill, in 1748, and by John Huxham, in 1757, in works (Account of the
sore throat attended with ulcers and Dissertation on the malignant, ulcer¬
ous sore-throat) that are commonly regarded as minor classics. This lends
especial interest to two theses on the subject written in the short period
between these two celebrated accounts, one thesis coming from Edinburgh,
the other from an English-speaking student at a leading Continental uni¬
versity, Leyden. It has suggested to us that it might be interesting to
compare such closely contemporaneous professional and student writings

103

104 EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

on a single topic which was, at the time, of more than academic concern.
As this may seem an over-severe test for ordinary graduation theses,
especially as they are much shorter than the recognized authoritative
treatises, it should be noted that Fothergill’s essay, in many ways the best
of the lot, was written at the age of 36, only two years after he had received
his license from the Royal College of Physicians.

In view of the rather limited list of classic subjects which for so long
dominated the field of the medical dissertation, it is not immaterial to
consider the frequency of appearance of this subject in the 18th century
doctoral dissertations. We find, on analyzing the entries under angina,
angina maligna, and croup (with their appropriate subdivisions) in the
first series of the Index-catalogue, that, before 1760, only 11 candidates
published theses on this subject; whereas, from 1760 to 1800, there were
32 dissertations on various aspects of it, 18 of these appearing in the last
decade of the century. Orme’s was the first on the subject published at
Edinburgh;^ Morris’ had one predecessor at Leyden, presented in 1724.
Only one other thesis (Greifswald, 1756) on the subject besides theirs
appears to have been published in the decade following Fothergill’s account
and preceding that of Huxham.

Leyden is often regarded as the mother of medical schools in the Eng¬
lish-speaking world. To it went a large number of British, and later,
American, students in the 17th and early 18th centuries. The school at
Edinburgh carried on its teachings, and from Edinburgh (as well as
directly from Leyden) they were brought to Philadelphia and the first
medical school in the North American continent. This connection brings
supplementary interest, we believe, to the publication of translations of
almost contemporaneous theses from the two schools which most pro¬
foundly influenced the course of American medicine. That the Leyden
candidate, furthermore, happened to be a student from the new world can¬
not be regarded as of signal importance, for reasons that will appear later
on, but the fact surely adds some poetic value to the juxtaposition.

David Orme and De Angina Inflammatoria, Edinburgh, 1749

David Orme,® a native of Scotland, seems to have passed the greater
part of his professional life in or near London. He was admitted Licenti-

* List of the Graduates in Medicine in the University of Edinburgh, from MDCCV. to
MDCCCLXVI." Edinburgh, 1867.

* Biographical data on Orme comes from Munk’s Roll of the Royal College of Physi¬
cians of London. 2. ed. London, 1878. Vol. 2, p. 267.

DISSERTATIO MEDICA

INAUGURALIS,

D E

ANGINA INFL AMMATORIA:

Q^U A M

ANNUENTE SUMMO NUMINC

Kk aufiii Uitti rcvcnnJi admoium viri

D. GULIELMI WISHART S. T. D.

ACADEMIAE EDINBURGENSIS PRAEFEGTI,

NEC NON

SENATUS ACAMMICI coftftnfu,
tlMhiliJ/Ime FACULTATIS MEDICAE ieeretoi

PRO GRADU DOCTORATUS,

SVMMISQVE IN MEDICINA IIONORIIVS ET PEIVILEOIII
KITE ET LEGITIME CONSEI^UENOIS
EEVDITOEUM EXAMINE lUBJIClT

David Oeme, Scotus* A.ctR.

Ad diem 29 Jnnii, hora locoque loliti*.

Homines ad Dees nstlia re frofisu accedsusi, qsutm fabstm b e sss imi su
daade, Cic*

EDINBURG I,

Apod T. et M'. Rudoimaiinoi. MiDC9CSJUJX>

Fig. 1.

Title-page of David Orme’s Edinburgh Dissertation.

(From the copy in the library of the College of Physicians of Philadelphia.)

105

106

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

ate of the Royal College of Physicians of London, June 25, 1765, and
held the office of man-midwife extraordinary to the City of London Lying-
in Hospital. He died on April 4, 1812, in his eighty-fifth year. He was
thus about 23 years of age when he submitted his dissertation, which is
dedicated to his patron, David, Viscount Stormont, and to his kinsman,
John Middleton,® a physician of Bristol.

The Edinburgh medical faculty in 1749 was a distinguished one. It com¬
prised Robert Whytt (medicine and physiology); Alexander Monro
primus (anatomy); Robert Smith (midwifery); Andrew Plummer
(chemistry and medicine); Charles Alston (medicine and botany); John
Stewart (natural philosophy). In the extra-academical school, in which
students acquired clinical instruction, the faculty and subjects in 1749 were
as follows: Andrew St. Clair and John Rutherford (medicine and
surgery); Andrew Plummer (chemistry).* Whytt, Monro, Plummer,
St. Clair, and Rutherford all had been pupils of Boerhaave, at Leyden.

Orme’s classmates included 5 Scots, 4 Irishmen, 1 Englishman, and 1
American, John Moultrie, of South Carolina. Only Orme and the Ameri¬
can, Moultrie,® wrote on subjects that might be regarded as outside the
classic range at that time, the theses of the others bearing such titles as:
De Haemorrhoidibus; De Pleuritide; De Fluore Albo; De Calculo
Vesicae; De Luce; De Peripneumonia Vera; De Hepatitide; De Scro-
phula; and De Lumbricis.*

Translation of Orme’s Medical Dissertation on Inflammatory Angina’’

However great the nobility and dignity of the medical art, all agree that it does
not stand in want of an elogium. For whoever ponders the laws of human life,
the fragility of our body and the causes of the numberless diseases by which it is
daily encompassed, easily will recognize the utility of that art which promises safety
to men in danger: of old, indeed, those who excelled in this art, on account of the
l*enefits they conferred on men, oftentimes were enrolled in the company of the Gods.

But since the practice of medicine offers great danger that it may be exercised
by unskilled and unlearned men, the laws of this Academy decree that whoever
seeks the doctoral rank submit himself to examination by the professors, and proffer

* Author of A Short Essay on the Operation of Lithotomy. London, 1727.

* J. D. Comrie, History of Scottish Medicine. 2. ed. London, 1932. Vol. 2, pp. 628 ff.

‘ His thesis, De Febre Maligna Biliosa Atnericae, was reprinted, in 1768, in the Prus¬
sian town of Langensalza, with a preface by the well-known German army surgeon and
medical historian E. G. Baldinger.

‘List of the Graduates in Medicine in the University of Edinburgh (footnote 1), p. 4.

’ References to authorities are given as they appear in the original text except in one
or two instances in which, on checking the source cited, we found the reference incorrect;
in such cases, the correct reference is given here.

Jim

ANGINA INFLAMMATORIA (DIPHTHERIA?)

107

a specimen of his diligence before he is elevated to the privileges and honor of a
doctor of medicine. This dissertation springs rather from compliance to my pro¬
fessors than from any pruritus scribendi, since I am abundantly conscious how ill-
equipped I am and that I have nothing new to say concerning angina (the disease
1 proposed for myself as the subject of this dissertation) which I have not drawn
from other authors.

This disease is called in Latin angina, from ayx<tv to strangle, because those
suffering with it are severely strangled and oftentimes afflicted with a feeling of
suffocation. Among the Greeks, however, a greater diversity of names is found,
for instance, xwdyx^, Xvydyxri and trwdyxi, because patients suffering with angina
often gasp for breath and let the tongue hang out as a dog, or a wolf, does when
fatigued by a long run; but awdyxq is used in a varying sense, for Celsus,® when
he is recounting the names which are given by the Greeks to the various kinds of
angina, says that it is called (svvdyxq when neither redness, nor any swelling, but
a dry body appears. But Aetius says that awayxg is that variety of angina which
is brought about by a dislocated vertebra in the neck. By other authors avvayx^
is used for any angina in which an external or internal swelling appears.

Angina was frequently called by the ancients an inflammation of the throat or
fauces. Thus Galen stated ® that it is (pXtyfMvtf riv Kara <f»apvyya ii*pw [an inflam¬
mation of the parts about the pharynx]. Hippocrates,^® nevertheless, seems to
distinguish inflammation of the fauces from angina, when he says, “ In some,
inflammation of the fauces was present, in others, anginas.”

The illustrious Boerhaave, who turns to almost nothing ineptly, was the first to
give us an accurate definition of this disease, as for instance: " Badly impeded,
very painful swallowing, or both impeded and painful deglutition and respiration
arising from a morbid cause passing into the dual parts serving these functions,
located above the lungs and above the stomach, is called angina.” And so it is
aptly distinguished from the other diseases which frequently trouble deglutition
and respiration.

Quite appropriately angina was divided by the ancients into true and spurious.
By true angina they understood obstruction of the red blood in the minimal vessels;
by spurious, a swelling from congestion of pituita, serum, or some viscous humor
without concomitant fever.

By Hippocrates^® angfina is divided into two kinds: in the first no swelling
appears, though respiration is so difficult and laborious that it cannot be carried
out except in an erect position and with the mouth open. The other variety is
characterized by a conspicuous swelling somewhere about the fauces. And just as
this division deserves to be retained, it will be clear to any one weighing the matter
how much more dangerous the former variety is than the latter. For it depends
indeed either on inflammation of the interior larynx or the arteria aspera [wind¬
pipe], or on muscle spasm or paralysis. It can be designated by various names,
according to the matter contained in the swelling, as edematous, inflammatory,
suppurative, scirrhous, or gangrenous.

’ lib. iv. cap. iv. p. 1%.

* lib. de ratione victus in acutis, text. 20.

Epid. lib. vi. § vii.

"Aph. 783.

lib. 3. de morb. epid. § x.

108 EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

Since I propose to treat here only of inflammatory angina, it is advantageous
first to observe that the proximate cause of it is always so g^reat an accumulation
of blood in the minimal vessels that pain, swelling, redness, fever, and other custo¬
mary signs of inflammation are produced, along with injury to the part thus affected.

Moreover obstruction of the vessels and accumulation of the liquid comes about
through a defect in either the blood or the vessels, the blood being at fault, how
many times, either quantitatively or qualitatively; for if so great a quantity of it is
present that it distends some of the vessels too greatly, it compresses the neighbor¬
ing ones; whence it has been observed by Senert [sic] and others that young people
are rather more susceptible to this disease than are old ones. If it be too thick or
viscous, the molecules gathered together in the narrow passages of the vessels are
unable to g^t through without obstruction.

Obstruction is produced by a defect of the vessels from any cause that makes
them compressed and narrower—and the cause may be multiple, e. g., too gireat
contraction of the fibres, or external force. Finally, the same effect is produced by
local failure, when the globules of the blood are driven into the dilated orifices of
the lateral, serous, or lymphatic vessels, and stick fast in the collapsing narrow
passages.

Granted that the remote causes of inflammation may be regarded as almost
without number, nevertheless it is helpful to name only those of them that par¬
ticularly excite this disease in the fauces. Such are the ingestion of acids (for
instance, of food, drink, medicaments, poison) and their contact with the larynx,
pharynx, upper esophagus, or arteria aspera, which irritate the fibres and contract
the vessels so that they are unable to transmit their usual humors. To this can be
referred the action of cold on these parts, since it at the same time restrains the
canals and causes the htunors to coagulate; and so in two ways induces the worst
kind of obstructions: whence it happens that in winter and cold weather angina
occurs more frequently than under more moderate weather conditions, especially
if one then goes in for vigorous physical exercise or for horse-back riding at a
rapid gate and facing a cold wind; for when the respiration is accelerated thereby,
the parts about the fauces, struck repeatedly by the cold air drawn to them, become
quickly inflamed.

Above all, excessive exercise of these parts is wont to excite angina, such as
singling, shouting, playing the trumpet; and thus not only is great force brought
to bear on these parts, but also, the humidity being dissipated, they begpn to become
dry and stiff, whence inflammation arises in the crispated [meaning?] vessels.

Indeed the cause of angina is sometimes epidemic, depending on a certain morbid
constitution of the air not known to us, which affects the parts about the fauces
more than it does other parts.

Finally, angina is sometimes produced by small bones, thorns, or other hard
bodies of the sort attracted unwarily into the arteria aspera or driven down into
the esophagus; impacted in these parts, they cause inflammation through their
liardness and roughness.

Thus inflammation arising around the fauces is bound to produce very varied
effects and various symptoms, impairing respiration or deglutition or both, accord¬
ing to the part it seizes. And he alone will be acceptable who distinguishes the
seat of the disease from the diversity of s)rmptoms, by whom the intricate anatomic
fabric of these parts has been studied and noted. Now therefore

ANGINA INFLAMMATORIA (DIPHTHERIA?)

109

First, if the disease has affected the upper part of the lar)mx, so that it has its
seat in the stretched out and nervous membrane investing the arytenoid cartilages,
or in the muscles and fibres dedicated to the closing of the rima glottidis, an angina
is caused which is without a swelling, the most deadly of all, and strangling very
quickly. This can be recognized by these signs: acute fever, sharp pain of the part,
increased inspiration, sharp and stridulous voice, gaping mouth, a feeling of suffo¬
cation, great pectoral discomfort, inflation of all the veins around the neck and
interior of the mouth, bloodshot eyes, and impaired cerebral function: all of which
depend on contraction of the rima glottidis and more difficult ingfress of air into
the lungfs, whence its inflation and movement is stopped and the passage of the
blood through the viscus, so necessary to life, is intercepted. And so in this angina
fatal peripneumonia quickly supervenes; and, an obstacle having been created in
the lungs, the right ventricle, right auricle, and vena cava become so swollen with
accumulated blood that the jugular veins referring the blood from the head, now
unable to discharge their function, swell up with a congested tumor.

Second, if the inflammation has its seat a little lower down, not so much in the
larynx as in the interior membrane of the arteria aspera, then respiration will also
be difficult and sibilant and the remaining symptoms will appear as in the former
case, but not so acute and ominous. For swallowing, in some measure impaired in
the former case, in this one is scarcely affected; and no swelling will be present,
but the pain will be increased on strong external pressure.

Third, if the muscles serving to elevate the larynx and the hyoid bone are
inflamed, redness and swelling in the fauces are observed; respiration remains
sufficiently free, but in the first act of swallowing a very sharp pain is felt, sometimes
exciting ccmvulsions.

Fourth, when inflammation invades the pharynx, it causes impairment of deglu¬
tition but not of respiration, though one kind can bring even this about, according
as it has its seat higher or lower down in the stomach. For if the orifice of the
phamyx, with the muscles serving to open it, is inflamed, inspection of the fauces
detects the disease through redness and swelling; and if, in swallowing, the patient
dilates the larynx, the severest pain is excited, and the dislodged matter (especially
if it be liquid, as it often is), since it is unable to go down the closed tube, is ejected
through the nostrils by a convulsive movement of the parts, or perhaps slips into
the arteria aspera and excites violent coughing.

Fifth, if the inflammation affects only the muscle of the esophagus and the
membrane of this tube, it furnishes no outward sign but badly impedes deglutition
almost as in the former case; and since the esophagus descends close to the verte¬
brae of the back, pain is felt even in these, as Galen observed of old.^*

Sixth, the most frequent angina of all is that which inflames the tonsils, uvula,
and velum pendulum palati, [soft palate], and which, on ocular inspection of the
fauces, appears immediately in the redness and swelling of these parts, which, when
in the act of deglutition they ought to be loosened and moved in varying ways,
now, rigid with inflammation and almost immobile, are thus unable to be moved
without great pain. These parts also become so swollen sometimes that, by pressing
down the epiglottis, they close the rima of the arteria aspera and almost suffocate
the patient, the ingress of air being impeded; and since, especially in the amygdalae

” Lib. V. de loc. aff.

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

[tonsils], many crypts and glandular lacunae are observed, these, now perfused
with a greater supply of liquid, continuously give off copious and sticky mucus,
which the patient often by very painful hawking attempts to expel, to keep too great
an accumulation from overloading the larynx and inhibiting respiration: since,
furthermore, the Eustachian tube, extending from the fauces to the inner ear, is
connected with these inflamed parts, it is no wonder if inflammation is often pro¬
pagated through its course to such an extent that patients suffering with this type
of angina often complain of pain in the ear.

Though I have here considered these varieties of inflammatory angina as indi¬
vidual and distinct, it nevertheless often, even very frequently, happens that they
are found joined and combined in various ways in the same patient, so that a great
diversity of s)Tnptoms may occur in divers patients, and often swallowing and
respiration are impaired at the same time.

The various effects and distinctive features of inflammatory ang^ina having thus
been set forth, prognosis becomes clearer. Generally unfavorable, it intimates some
degree of danger, since this disease either injures the respiration, on which life
immediately depends, or impedes swallowing by the aid of which new aliments are
taken in with which the perpetual expenditures of the body are repaired.

In general, the more acute the fever and the sharper the pain, the more dangerous
is the disease, especially if the respiration be much injured, with great discomfort
and constriction of the chest; and so the first type of the disease is often, and indeed
quickly, fatal: for unless the inflammation is immediately resolved, the patient will
suffocate before the disease can either progress far or turn to suppuration.

Nor is there anything favorable in the second type, unless it can be predicted
from a benignant and speedy resolution. Greater hope of recovery appears in the
remaining forms of the disease.

If the pharynx only is inflamed, and the patient can still breathe freely, this type
is less dangerous; for though swallowing may be prohibited, the patient can, never¬
theless, live a long time without nourishment, as Hippocrates observed^* of old,
or be sustained and nourished for some time by means of clysters, until either the
inflammation is resolved or the swelling of the parts subsides either by suppuration
or breaking of the abscess.

Greater hope also is promised one suffering from angina if the swelling appears
on the external part of the neck, as Hippocrates notes,'® adding the reason that the
disease is then turned outward.

But if the swelling, whether external or inside the mouth, suddenly disappears,
and the other symptoms of the disease do not diminish but rather are increased,
then the morbid matter passes by metastasis to other and interior parts of the body;
whence, seeking the brain, it produces phrenitis, or adhering to a lung, causes
peripneumonia, on the testimony of the same Hippocrates.'*

Haemorrhage of the nose, or bowel flux, supervening in angina, and bringii^
alleviation, is regarded as a good sign by all authors.

If the inflammation leads to abscesses, then, as Forestus observes,” the outcome
will be more doubtful.

If angina arises through metastasis from another inflammatory disease, the

'* lib. iv. epidem. 7. '* Aph. 10. § 5.

'* Aph. 27. § 6. lib. xxv. observ. xxiv.

ANGINA INFLAMMATORIA (DIPHTHERIA?) Ill

greatest danger is announced, because the patient, weakened by the prior disease,
will be ill able to sustain the attack of this new one.

These points having been laid down, I shall proceed to the method of healing.

This disease, since it hangs on inflammation, should run the accustomed course
of inflammation and terminate in resolution, suppuration, scirrhus, or gangp’ene,
examples of all of which mutations are offered by the authors; but since I have
undertaken to treat here only of the disease in its inflammatory state, I shall add
only a few of those remedies by which it can be resolved.

Resolution is indeed the most perfect method of cure, since it throws open the
obstructed vessels and regulates the swollen ones without bringing further injury
to the part. Therefore in all kinds of inflammatory disease, this salubrious chang^e
is most to be hoped for, but in none more than in angina, which so hinders the parts
necessary to respiration and life that it offers neither pause nor delay in which to
institute any other method of healing. To bring it about properly, the chief indica¬
tions seem to be as follows:

First, to diminish the supply and force of the blood in the affected part.

Second, to disperse the force of the disease into other parts.

Third, to attenuate and dilute the clammy consistency and viscidity of the blood.

For the first indication bleeding responds above any other remedy, provided the
supply be sufficiently copious; and if the symptoms urge it, let it be instituted even
to the loss of consciousness; for in this aid the ancient physicians put an especial
and almost sole hope of cure. So prescribes the father of the art: “ In those

afflicted with angina from blood collected and coagulated in the veins of the neck,
draw blood from the veins of the arms and feet, and at the same time purge the
bowels below, to draw out what has produced the disease.” Some later physicians
indeed advise section of the sublingual veins, others indeed of the jugular veins;
while many, not of lesser note, believe it matters little from what part of the body
the blood is drawn, provided it flows with the proper force and speed, so that the
vessels, formerly distended, are quickly depleted, and the force of the blood is led
from them to the opened vein.

To the same purpose, after the bleeding, it will be advantageous to supply a
purgative remedy, according to Hippocrates and Celsus; for in this way the velocity
and the quantity of the blood are diminished, the crasis of the surviving humor is
attenuated, and the force of the blood is led from the affected part to the lower ones.
Cathartics on this occasion should be so chosen and prepared that they can be easily
taken by the patient; or if swallowing is prohibited, as often happens in this disease,
then purgatives in the form of clysters should be injected.

To satisfy the second indication, these remedies are provided—cupping glasses
and epispastics applied to the neck, shoulders, and back. Sinapisms also are applied
to the lower parts of the body, and warm baths, cataplasms, and emollient foments
applied externally.

That, finally, the clammy consistency of the blood may be corrected, by which it
is rendered immobile, and likely to adhere to the narrow passages of the vessels,
it is required first that it be diluted with watery things, then that the particles
cohering be dissolved with attenuant remedies, v. c. nitre, tartarus regeneratus and
especially spirit of Mindererus.

'* lib. de loc. in horn. § 1.

112

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

Many topical remedies, also, are of advantage, especially gargles, which can be
made of various sorts according to the circumstance, such as emollients, detergents,
attenuants, or slight astringents, if too great relaxation of the vessels indicates
such things. It will be advantageous also if the patient receive through a funnel in
his fauces the vapor exhaled from a warm decoction of herbs.

But if the disease is very violent and the respiration much injured, before all
these things can be done, there will be fear of the patient’s suffocating. To prevent
this, the ancient physicians devised an operation—laryngotomy or bronchotomy:
an incision having been made between the annuli of the arteria aspera, an opening
is made with the aid of which air can be drawn into the lungs. The fauces are not
healed until the inflamed part is resolved or suppurated, provided the patient
meanwhile is sustained and nourished by clysters injected daily.

Finally, let there be food and drink (if the patient is able to take them) which
is soft, light, delicate and cooling; let the air be kept at a moderate temperature,
the bowels be kept open; and let the body be kept at rest, the mind free of worries.

Ill

Benjamin Morris and De Angina Vera seu Inflammatoria, Leyden,

1750.

Benjamin Morris died at the early age of thirty, five years after his dis¬
sertation had won the approval of the medical faculty at Leyden. It is not
to be expected, then, that he would have left much of a biographical or
professional nature to be recorded, and he did not do so. It is fitting,
however, that we present here the little we have been able to learn
concerning him,^*

Dr. Morris came of a prominent Philadelphia Quaker family, whose
first American ancestor was the English-bom Anthony Morris (1654-
1721), mayor of Philadelphia for the year 1703-4. Bom in Philadelphia
in 1725, Benjamin Morris must have enjoyed as a youth the best advan¬
tages the young city then afforded. A bookplate bearing his name and
the date 1744 attests to an early interest in learning. His thesis is dedi¬
cated to the eminent Philadelphia physicians Thomas Bond, Thomas Cad-
walader, and Phineas Bond, to whom, he says, he is “ obligated for many
kindnesses "—leaving the unavoidable impression that he had studied
medicine under these men before setting out for Europe. All three of these
physicians, incidentally, had pursued medical studies in Europe; Phineas

Biographical data on Morris chiefly from: Moon, Robert C. The Morris Family of
Philadelphia, Descendants of Anthony Morris 1654-1721. Phila., 1898 . We are much
indebted to Miss Florence Greim, assistant to the administrator of the Pennsylvania
Hospital, and to various members of the Morris family, for many kindnesses during our
search for material on the life of Benjamin Morris.

“ In his copy of Aretaeus, in the possession of the Pennsylvania Hospital.

ANGINA VERA SEU
INFLAMMATORLL

M . V u M

ANNUBNTB OEO TBB OPT. MAX.

Bat jt t S m ’H m MAaaiiici Bicroaii |

D. FREDERICI WINTER^ !

MED. DOCT. XT PBOrESSORII. SEBENIU. ARAOS.

IT NASSAY. PRINCIPIS ARCHIATRI. ^

SiWATM Acabihici C mf t i fn , tMUfim

FACULTATIt MlBtCa IMbVM, '

PRO ORADU OOCTORATUS,

\ 5»wifi|T MisiciaA H iBAci t w > H Pa«iiifii( nwt M 1 )|Um

j RraAtraw Rr — » «< Jitmkik

■ ENJAMINUS MORRIS, Pinitlyamibmiir

Jtd dimm }«. D t mmt rl i ij$m. ttri kmfm fiBix.

PhatMi iilvei dovim iagrctUtar toa niMja Oewdot.

H Tibvlaui^ 1

Fig. 2.

Title-page of Benjamin Morris’ Leyden Dissertation.

(Courtesy of the Historical Society of Pennsylvania. The library stamp indicates previous ownership.)

113

114

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, liD

Bond, indeed, was inscribed as a student at Leyden in August, 1742, one
nn^nth after having obtained his medical degree at Rheims.

In 1748, Benjamin Morris went to England, judging from a certificate
of removal to Grace C'hurch Meeting, in London. His status as a member
of a prominent Philadelphia Quaker family, and his interest in medicine,
|X)int to the probability of his having made the acipiaintance of the Eng¬
lish Quaker physician John Fothergill, whose interest in and influence
on American medicine is well known; yet there is no evidence in Morris’
thesis of his having knowledge of Fothergill’s treatise, published in the
very year of Morris’ arrival in London.

Morris was inscribed at Leyden on July 29, 1750,'* obtaining his medi¬
cal degree five months later. His activities are not again on record until
the year 1754, when he presented to the Monthly Meeting of Philadelphia
a certificate from the Two Weeks Meeting, in London, testifying to the
sobriety of his conversation and to the fact that he was clear of marriage
engagements. He died, unmarried, in Philadelphia a year later. May 14,
1750.

Two years after Dr. Morris’ death, his sister, Deborah Morris, jire-
sented to the Pennsylvania Hospital “ a human skeleton, for the purpose
of medical teaching.” -- The natural supposition that the skeleton had been
the property of her brother is supported by Deborah Morris’ gift to the
Hospital, ten years later (1767), of 55 books, “principally standard
medical works, collected by Dr. Morris during his attendance upon the
L'niversity of Leyden.” " A silver corkscrew owned by Dr. Morris, and
now in the possession of the Hospital, suggests the possibility of a lighter
side to the worthy character of this young Quaker physician.

The 1790 “ Catalogue of the Ixioks belonging to the medical library in
The Pennsylvania Hospital ” lists thirty-three books as gifts of Deborah
Morris. We give the list as an interesting examjile of a library collected
by a young American student in luirope in the mid-18th century for use
on his return to his native city.

Ancient Authors

Aretaeus. De causis et signis acutorum et diuturnoruni niorborum. Leyden, 1735.
Caelius Aurelianus. De morbis acutis et chronicis. Amsterdam, 1722.

Celsus. De medicina. Leyden. 1746.

Hippocrates. Opera omnia, gracce et latine. 2 vols. Leyden, 1665.

’‘Smith, R. W. Innes. English-speaking Students of Medicine at the l'niversity of
Leyden. Edinburgh. 1932.

’’Morton, T. G., and Woodbury, F. The History of the Pennsylvania Hospital, 175^~
1805. Phila., 1895. P. 356.

” Ibid., p. .147.

115

ANGINA INFLAMMATORIA (DIPHTHERIA?)

16th-17th Century Authors

Alpinus, Prosper (1553-1617). De praesagienda vita et morte. Leyden, 1733.
Forestus, Petrus (1522-1597). Opera omnia. Frankfurt, 1634.

Piso, Nic. (1527-1633). De cognoscendis et curandis praecipue intemis humani
corporis morbis. 2 vols. Leyden, 1736.

Plater, Felix (1536-1614). Praxeos medicae tomi tres . . . Ed. 4. Basel, 1736.
Schenck a Grafenberg, J. (1530-1598). IlapaTjypijovwv sive observationum medi-
carum, rararum, novarum, admirabilium et monstrosarum volumen . . .
Frankfurt, 1609.

Tulp, Nic. (1593-1674). Observationes medicae. Ed. 6. Leyden, 1739.

Zacutus Lusitanus (1575-1642). Tomus IX (Praxis historiarumT). Amsterdam,
1642.

17th-18th Century Authors

Baglivi, G. (1668-1707). Opera omnia. Lyon, 1745.

Bellini, Laur. (1643-1704). Opera omnia. Venice, 1732.

Boerhaave, H. (1668-1738). Praelectiones academicae in proprias institutiones rei
medicae. Edidit A. Haller. Ed. 2. Gottingen, 1740.

-Aphorismi. Leyden, 1737.

- Institutiones medicae. Ed. 3. Leyden, 1720.

-The same. Institutions in ph3'sic. Transl. by J. Browne. London, 1714.

Coward, William (1657F-1725). Ophthalmiatria . . . London, 1706.

Deckers [Dekkers], F. (1648-1720). Praxis Barbettiana . . . Amsterdam, 1678.
Degnerus, J. H. (1687-1756). Historia medica de dysenteria bilioso-contagiosa...
Utrecht, 1738.

Freind, J. (1675-1728). Emmenologia . . . Ed. 2. London, 1717.

Gaubius, H. D. (1705-1780). De methodo concinnandi formulas medicamentorum.
Ed. 4. Frankfort and Mainz, 1750.

Hoffmann, F. (1660-1742). Opera omnia. Geneva, 1748. Suppl., 1749.

Linnaeus, C. (1707-1778). Species plantarum ... 2 vols. Stockholm, 1753.
Pharmacopoeia Collegii regalis medicorum Londinensis. London, 1747.
Pharmacopoeia Leidensis. Leyden, 1751.

Pitcairn, A. (1662-1713). Opuscula medica . . . Rotterdam, 1714.

Quesnay, F. (1694-1774). Traite de la gangrene. Paris. 1749.
van Swieten, G. (1700-1772). Commentaria in Hermanni Boerhaavii aphorismos.
Leyden, 1743. (Vols. 1 and 3.)

Sydenham, T. (1624-1689). Dissertatio epistolaris ... ad Gulielmum Cole . . .
de observationibus nuperis circa curationem variolarum confluentium nec
non de affectione hysterica. London, n. d.

Waldschmidt, J. J. (1644-1689). Praxis medicinae rationalis. Paris, 1691.
Wepfer, J. J. (1620-1695). Historia cicutae aquaticae. Leyden, 1733.

It is interesting to note that of the ancient authors Aretaeus, Celsus,
and Hippocrates are cited in Morris’ dissertation; but, among the later
authors, only Boerhaave (naturally), Tulp, and Sydenham (the Opera
omnia) are mentioned. The number of 18th (and even middle 18th cen-

116

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

tury) editions leaves little doubt, however, that many of the rest of these
texts passed for currency at the Leyden school. Morris, on the other hand,
cites a number of authors not represented in the part of his library of
which we have knowledge—Keill (James, 1673-1719?) Riverius (1589-
1655), Winslow (1669-1760), Sharp (1700P-1778), and Oosterdyk-
Schacht (1704-1755), three of whom, it may be seen, were living in
1750; 18th century editions of all were available.

We do not know under which members of the Leyden faculty Morris
carried on his studies, but the faculty included the following in 1750:**
the brothers Albinus; Frederick Winter; Gaub (represented in Morris’
library) ; Musschenbroek; and van Royen.

The other English-speaking medical students at Leyden while Morris
was in residence there were three Irishmen, Henry Archdeacon, John
Michael Daly, and Simon Lynch; an “Anglo-American” (presumably
from the West Indies), Fortune Dwarris; and an Englishman, Richard
Milnes. The theses ascribed to them—De venaesectione; De catameniis;
De tenesmo—obviously followed the classic line in subject matter.*®

Translation of Morris’ De Angina Vera seu Inflammatoria'’’^*

Every morbid affection of the fauces and throat which impairs respiration or
swallowing, either one or both at once, is called by the general name of angpna.
It is divided by authors into several varieties, of which the causes are as varied
as the methods of cure. But since it would be too lengthy to speak of each and
every one, I have undertaken to treat of that variety only, a very dangerous one,
which is called inflammatory angina. Its symptoms, causes, effects, and cure I now
set about to explore with such brevity as the subject permits.

II.

Thus, inflammatory angina is an acute affection of the throat situated in the
internal or external muscles of the larynx, pharynx, or neighboring parts. Hence,
on account of the diversity of its seats, the ancients have divided it into internal
and external; but also the celebrated Boerhaave instituted a further division,*’
and distinguished inflammation of the larynx from that which seizes the muscular
membrane of the aspera arteria [windpipe] and the erector muscles of the hyoid

** We are indebted to Dr. Claudius F. Mayer, of the Army Medical Library, for kindly
supplying us with information regarding the Leyden faculty.

“Smith (footnote 21).

” We have used the cities of both Orme’s and Morris’ dissertations in the library of
the College of Physicians of Philadelphia. An English bookseller in the past year or two
advertised a copy of Morris’ at 25 i, stating that it was “ not in Surgeon General’s, not
in Bibl. Osleriana, not in Roy. Coll, of Physicians.”

” Celsus Lib. IV. p. 1%.

ANGINA INFLAMMATORIA (DIPHTHERIA?) 117

bone and larynx. But since this disease, as indammatory, requires to be discussed
whether it have the injury situated in the larynx, pharynx, or some other neighbor¬
ing part, it will perhaps suffice here to observe the number and violence of the
symptoms, according to which the affection has to be judged either of the lighter
or of the more dangerous sort, and the curative indications be fulfilled in conformity,
so that an attempt may be made to cure the disease either quickly or slowly.

III.

This disease invades with a stiffness, soon followed by fever, burning heat with
a stabbing pain in the inner part of the throat, a swelling and reddening of the
fauces, swollen tongue, redness of the face and eyes, difficulty of respiration,
swallowing, either or both, pain increased by the act of swallowing, voice shrill,
and inflammation now and then of the muscles of the inferior maxilla that are used
for motion. If the disease has acquired its seat in the external muscles or adjacent
parts, the diagnosis lies open to the eye; but if it has become fixed rather in the
internal parts, there is nothing visible to which these violent symptoms can be
ascribed. And this is the most dangerous variety of the disease in the opinion of
Hippocrates, when he says: “ the most horrible forms of angina, and the most
quickly fatal, are those which neither in the throat or neck produce anything
noticeable.” Vid. Praenotiones Lib. XXXV. Sec. XXV. And a little farther on
he adds, “ for these cause suffocation on the same day, the second day, likewise,
and the third and fourth.” For since in this case the larynx itself is more imme¬
diately affected, danger of suffocation will threaten, on account of the violent
inflammatory stricture of the thyro-arytaenoideus and arytaenoideus muscles, which
form the rima glottidis, and the inflammation of the muscular membrane of the
trachea. But if inflammation has seized the internal muscles of the pharynx in
particular, difficulty in swallowing, though respiration remain unimpaired, will
easily make it known.

IV.

On account of the diversity of the parts first affected, varied also will be the
order of symptoms: thus, if inflammation settles in the larynx first, the first symp¬
toms will be painful respiration, swelling, with the voice becoming shrill. If the
internal muscles of the pharynx are seized with inflammation first, then the patient
will complain of an impediment to deglutition, of swelling and pain in those parts,
greatly increased at the time of deglutition, in that the hyothyreoid muscles intended
for raising the hyoid bone in this action are attacked by the inflammation.**

This variety of ang^ina, on examination, can be distinguished from all the other
varieties enumerated by various authors by the heat and dryness of the affected
part; and indeed its location will be thereupon revealed. It is distingfuished from
a trivial and ordinary swelling of the gullet by impaired exercise of deglutition
and respiration; absence of pain, and brief duration, differentiate ours from that
which has its origin in an hysterical or hypochondriacal affection. Catarrhal angina
can be distinguished from the inflammatory variety through the vast flux of serous
humor from the excretory vessels located there, particularly tumefaction of the
glands, less acute symptoms and a slower course than in that variety with which

" Keil [Keill], p. 127.

118

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

we are concerned. The phenomena of this disease having thus been explained,
and its signs enumerated, order demands that we investigate its causes. These are:

VI.

The causes of inflammation in general: above all, a plethoric habit of the body,
.such as frequently obtains in the young (vide Riverius, Prax. Med. Lib. VI. Cap,
VII). Perspiration impeded by a sudden change in the weather, sudden exposure
of the heated body to cold after violent exercise; rarefaction of the blood in the
capillary arteries of the fauces, suppression of the menses, of haemorrhoids, of
accustomed haemorrhage of the nostrils, any usual evacuations that have been
omitted, suddenly evanescent erysipelatous humors, epidemic fevers in which febrile
matter is transferred to these parts, or putrid matter resorbed from its first channels
into the blood. Hence it is clear that this disease can be the effect of a fever of
earlier origin, but the fever can equally well be symptomatic; certainly so, if the
angina has its origin in external causes, such as cold drinks, cold winds, violent
exercise of the parts, as long continued outcries, singing, blowing of trumpets, etc.
Or in these same parts too great dryness is induced in some manner or other,
whence they become rigid, the capillary vessels collapse and deny transit to the
blood, and so from irritation and the tonic constriction of these parts inflammation
is induced. “ Tonic constriction ” I wish to have understood as merely that ability
which every sensitive fibre possesses of contracting itself independently of any
distending source, in which it differs from muscular action, in that, imperceptible
and demonstrable only by the feelings, it has a relationship with the elasticity and
very powerful tension of the parts. Now we turn to an examination of the effects.

VII.

These are effects of congestion —indisputably a swelling of the part and redness
from blood impacted in the most remote blood vessels and the lymphatic arteries;
and of tonic constriction, producing heat and pain. These two primary affections
draw after them several other secondary ones, aiming at dissolution of the machine
itself. Congestion of the blood in any part produces a derivation of the same in a
neighboring part. The effects of heat are: First: To dissipate the watery part of
the blood. Second: To coagulate the lymph, to thicken the membranes through
condensation of the vessels.

The effects of pain are, first, wakefulness and all the ills arising therefrom;
second, universal tonic constriction of all the fibres of the body; whence fever,
and its multiple sequelae, and indeed an interruption of the secretions while the
fever rages at its height. Therefore here are to be seen all the causes of acute fever
and of the violent inflammation of these parts. When it has communicated itself
to the neighboring parts, the orifices of the vessels, through which nature is accus¬
tomed to pour the mucous humor adapted to lubricating the fauces, are occluded,
or the liquors they contain are so thickened, and so firmly impacted in the vessels
crispated by the inflammation, that they straightway become impassable. Hence
tension and the irksome burning heat are continuously increased.

VIII.

But why the febrile matter settles in these parts in putrid and epidemic fevers
it is not easy to say, unless this is to be attributed to the greater sensitivity of these

ANGINA INFLAMMATORIA (DIPHTHERIA?)

119

parts: to which can be added the great amount of blood flowing toward the head
and neck. For experience itself confirms that, the greater the natural tension and
sensitivity of any part, the more that part becomes liable to a greater flux of the
humors; indeed the violence of the inflammation increases in proportion to this
same sensitivity, and is terminated more slowly or speedily accordingly. Thence,
if the nerve fibres of the intestines shall have been the more sensitive and more
irritable, the morbid matter is transferred there rather than to another one of the
viscera which is, other things being equal, less sensitive; therefore, it is the primary
fabric of the fibres and their innate sensitivity that determines these flowings to
certain parts. It is not a matter of much labor to produce reasons why external
causes induce these various ill effects in the fauces and jugulum, if we but consider
the constant use of these parts, their situation, and their perpetual exposure to
cold air.

When inflammation has persisted for some time, the neighboring veins are so
compressed by the arteries, swollen and infarcted with blood, that transit of the
blood which should be drawn back through the jugular veins is impeded. Hence
the blood flows in greater quantity and with greater vigor to the vessels of the
head, distending thereby the vessels of the face, eyes, and the brain itself—whence
come, in the former, the redness, in the latter, pain, coma, etc. In this affection it
often happens that the velum pendulum palati [soft palate] becomes so inflamed
that it is unable to be expanded sufficiently for the closing of the foramen leading
from the pharynx to the nostrils; hence, while this remains open, whatever has
slipped down into the pharynx will regurgfitate to the nostrils; but when the patient
attempts, with the greatest effort, to swallow food, it will come about that, if he is
taking food that is part liquid, part solid—for example, milk or gravy with bread—
in the violent act of swallowing, the solid part, from its own weight and opposition,
will make a way for itself into the esophagus, while the liquid, pushed back behind
the velum pendulum palati, will pass into the nostrils. Hence, the patent difficulty
of supplying diluents to the blood in this way, while inflammation has hold of this
velum pendulum. On the other hand, sometimes the condition is such that fluids
are easily swallowed, but solids not at all; while the velum pendulum, to be sure,
is free of inflammation, the pharynx is attacked by it.

This disease proceeds through all its stages quickly or slowly according to the
varying degree of its violence. The critical and, because of fatal termination of
the disease, infamous days are commonly thought to be the Sth, 7th, 9th; though
according to the observation of the above lauded Hippocrates, death can occur on
the 2d, 3d, or 4th day. But indeed this disease now and then rushes to destruction
so violently and precipitously that even on the very day they are attacked patients
are sometimes snatched from the living, as was observed by the divine ancient.
Then, if the disease is protracted to the 7th day, it must now be violent, many
vessels having been rendered impassable by the very violent constriction of the
fibres, and the most fluid part of the blood having been dispersed, which alone was
able to get through the narrow orifices of the capillary ducts so constricted. The

120

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

blood, thicker then, bereft of its liquid part and more tenaciously impacted, will
clot, and the obstruction cause pain every moment of the time.

Injection demonstrates anastomosis of the vessels of these parts, which ramifica¬
tions of the external carotid are called by the celebrated Winslow arteria gutturalis
and anterior cervicalis. Hence, if the inflammation be violent, arising in the larynx,
of necessity, on account of this anastomosis of the vessels, it will extend itself to
the phamyx and neighboring parts; and, vice versa, it will easily be communicated
to the larynx from the pharynx for the same reason. Hence it comes about that
true angina, unless the violence of the disease has brought the patient to a sudden
end, rarely attacks the larynx without making its neighbor, the pharynx, also a
fellow sufferer, on account of its propinquity, and vice versa. Because, in truth,
between these parts there lies only a soft glandular membrane, which suffers loss
of the cartilaginous rings in the posterior part of the trachea. Anatomy teaches,
moreover, that the common membrane of the pharynx is a continuation of the
membrane of the nose, and therein appears a spontaneous reason why that inflam¬
mation is spread even to the nose and impedes respiration through this organ,
which is a frequent and troublesome symptom of this disease.

XI.

If, therefore, inflammation attacks the larynx equally with the pharynx at the
same time (as must be the case if the disease continues on), the organs of respira¬
tion, as of swallowing, become either in part of wholly unequal to the performance
of their duties. The inflamed larynx and neighboring part of the arteria aspera,
whose muscular membrane is here attached, makes the passage narrower, and com¬
pels the air to go and come through these passages with greater effort now in the
act of exhaling than in that of inhalation. These parts, made very tender and
sensitive, hence are continuously and greatly irritated, and so respiration becomes
painful and laborious. But if an inflamed pharynx denies passage to food; or that
part or even the muscles of the hyoid bone become so irritable that they deter the
miserable patient from the exercise of swallowing; or if the epiglottis, inadequate
to its function of closing the passage to the trachea, permits some food to pass into
it in the midst of swallowing, a dreadful cough follows, which causes a deep fear
of swallowing in the patient. If, I say, it comes to that, great will be the danger
that the humors, undergoing continuous loss and destitute of new assistance, may
take on an acrimony. Whence a new fever and cause of inflammation will be added
to the earlier ones—for instance, a constant irritation of the vessels by acrid matter;
this acrimony, introduced through liquids in this passage, cannot be corrected for
reasons already mentioned. When, moreover, this acrimony constantly increases,
and the resulting symptoms become more and more urgent, in vain will resolution
of the inflammation be attempted, or with difficulty, will it be obtained, for which
indeed it is necessary that the humors and the swelling itself be of the bland sort.
Nor is this the place for repellents, lest through them the tension of the vessels,
already too great, be further extended. No greater hope of suppuration appears;
for this a moderate degree of heat and tonic constriction is a necessary requirement,
as also a bland condition of the humors, all of which are lacking.

Now, if inflammation cannot be mitigated by any aids, one or the other of these
results must follow: either the vessels will be suddenly ruptured or robbed of their

ANGINA INFLAMMATORIA (DIPHTHERIA?)

121

tone through excessive distention, with gangrene seizing the part; or if pus be
formed, it is forced into the circulatory passages, and causes metastasis to another
part: and here the most immediate danger will be that of transference of purulent
(natter to the brain or lungs. Because if it invades the brain, it induces phrenitis,
with death to follow shortly. If it is brought to the lungs, it produces an abscess
there, and hectic fever, which threatens a disaster slower in coming, granted, but
no less certain, according to Hippocrates, Aphor. X. V. [i. e., V, 10.] “ Those who
survive angina, and it turns to the lungs, die within 7 days.”

XII.

The same author affirms that this disease is protracted to the 9th day some¬
times : moreover we know that in this interval of time every inflammation reaches
its end; either in resolution, when tonic constriction ceases and the blood finds
means of transit into the veins or lateral branches of the arteries; or in suppura¬
tion, when the minimal capillary vessels, under pressure of the impacted liquids,
are worn out, and with the extravasated humors are changed into pus through
hindrance and heat. Or if the tonic constriction be so violent that pus cannot be
formed, suddenly the vessels lose their elasticity and are affected with gangrene.
In this last and most violent stage of this disease, the thyro-arytaenoideus and
arylaenoideus constrictor muscles of the glottis, violently inflamed, scarcely concede
the air passage to the lungs, whence the voice becomes somewhat shrill or very
faint. If, equally, the muscular membrane of the trachea be seized by inflammation,
the respiration becomes heavy, breathy, fast, so that the passage of the blood to
the lungs is procured with the greatest exertion. The pulse is hard and inter¬
mittent; the tongue very much swollen and of a ruddy, livid color, on account of
the veins choked therein; redness of the face and eyes, and their protuberance,
acknowledge the same cause; great anxiety and disquietude argues a difficult pas¬
sage of the blood from the right thalamus of the heart to the left auricle, owing to
the lack of air to distend the all but collapsed vessels of the lung^. Hence an
accumulation of blood in the lungs and true peripneumonia. The extremities
become cold and indicate that the life-forces are already failing. Unless aid is near
at hand, death quickly closes the tragedy.

XIII.

So various and changeable is the face of this disease, and its occurrence often
so unexpected, that a certain prognosis can scarcely be made concerning it. But
granted that it is permissible to form some judgment concerning its termination,
we shall consider those signs which are thought to be favorable, and also those
which experience has taught portend a fatal outcome.

Among the former are numbered an external swelling, free respiration, an
erysipelatous eruption on the neck and chest, or even sometimes over the whole
body. These signs Hippocrates pronounces favorable, when he holds as follows:
“ When the fauces and cervix are red, at the same time, these anginas are of long
duration, and generally pass off of their own accord, if both cervix and chest are
red and erysipelas of the sacred fire runs in with it” Critical haemorrhage of

” Vide Hippoc. de morbis Lib. III. Cap. 1C.

“ Praenot C. III.

122

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

the uterus, haemorrhoids, nose; critical diarrhoea, or sweat,supervening not
rarely remove this disease.

Among the fatal signs are thought to be acute fever accompanied by all the signs
of internal inflammation, the more dangerous as it approaches the respiratory
organs. Thus Hippocrates: “ Latent angina is fatal on the first or second day,” •*
which Tulp has confirmed in a separate observation. See Tulp. Observ. Med. Lib.
I. Cap. LI. Difficult respiration, a shrill voice, no apparent indication of external
inflammation, or sudden subsidence of an external swelling, erysipelas turning
inward, are bad. Sudden mitigation of all the symptoms without any previous
evacuation, fatal, for this signifies that the tone of the parts has been destroyed
and gangrene induced. If an abscess has formed in the larynx, there is danger that
purulent matter may fall into the thorax and prevent the patient from breathing.
Frothing at the mouth, a blackish tongfue, voice somewhat shrill, great anxiety,
hard and intermittent pulse indicate that death is knocking at the door.

XIV.

Inflammatory angina follows the ordinary course of inflammation and terminates
in resolution, suppuration, gangrene or some other disease; but excessive violence
of the disease rarely admits suppuration, as we have shown in sec. ix above.
Therefore, resolution, as it is the termination of this disease most to be desired,
should be attempted with every possible means, and the following indications to
that end will be abided by: First, Congestion demands depletion; Second, Tonic
constriction requires relaxation; Third, and last. Coagulated liquids demand
attenuants and repellents.

And here first place is claimed by venesection, which is to be sought according
to the violence of the inflammation and the strength of the patient. As to the place
in which venesection should be performed, physicians differ. Some order the arm,
others the tongue, jugulum, foot, the last of which seems best accomodated to the
doctrine of derivation and revulsion; but since the especial purpose is to evacuate
blood, it seems to matter little whether the blood be extracted from the arm or
from the foot. How advantageous and salutary revulsion from the head to the
abdomen is, nature herself demonstrates when suddenly she sometimes overcomes
this disease through premature diarrhoea. Hence all practitioners, venesection
having been performed first, order evacuation of the stomach, either through
clysters or through minoritive cathartics, in order that through more acrid medica¬
ments the humors be not unduly excited and that rarefaction of the blood which
the intention is to quiet be not extended.

As for the second indication: that is to be discharged by medicaments, some
taken internally, some applied externally. Diluents allied with antiphlogistics are
to be poured into the body in great quantity; let the food be slight and diluted,
and the air temperate, that the vessels may not be too much contracted by cold,
or the inflammation too much increased by heat; nor should cold things be given
the patient. Sydenham is authority for the statement that an erect position of the
patient in a chair for some hours daily, in the interests of his strength, brings no

” Oosterdyk Med. Prax. Lib. IV. C. II. § XXIII.
”Eib. [Lib.?l III. Prognos.

ANGINA INFLAMMATORIA (DIPHTHERIA?)

123

little comfort here as in many other inflammatory fevers;*® (because, in addition
to the resulting; moderate chilling of the blood from air that is less warm, the erect
position of the body itself makes it that the blood rushes with less force and quantity
to the upper parts). Topical emollients are called into use under the name of
cataplasms, fomentations, unguents. Celsus advises that sponges spread with warm
oil be applied to the jugulum.®* Vapors of warm water received in the fauces and
brought to the arteria aspera by means of the air are especially useful here. Emol¬
lient linctures held in the fauces for some time improve in good fashion the stiffness
and dryness of these parts. How far opium, whether applied directly or taken
internally in minute doses at proper intervals, is able to induce relaxation of the
parts, I leave to be determined by others who have more deeply studied the qualities
and peculiar power against topical constrictions, the ability to check rarefaction of
the blood, of this noble medicament. Freedom of the bowels must be preserved
with the greatest care; and with these is uncovered the entire method of cure at
this stage.

It will not be out of place to note here that angina sometimes is symptomatic;
in which case, if it does not require the special attention of a physician on account
of its violence, nevertheless there will be incumbent cure of the primary disease of
which it is a symptom; when that is disposed of, the angina arising from it will
recede equally. Such is the case if angina arises from putrid and undigestible
matter in the stomach and intestines and is resorbed from them into the mass of
blood, where it incites fever accompanied with this affection. The signs of it are
impaired appetite, repletions of the stomach manifested by their own indications, etc.
Cure is obtained through those things which cleanse the primary passages of their
putridity, through a single copious venesection, if the condition of the inflammation
requires this, and through ordinary topical remedies. This type of angina easily
yields to this method; but unless attention is given to the cause, it is accustomed
to create trouble for the patient and the physician.

XV.

If the disease has gained streng;th and the inflammation not been mitigated,
venesection must be renewed with regard to the strength of the patient, and use of
the above-mentioned remedies be persevered in. Vesicatories should be applied to
the back of the neck, and there should be called into use everything suitable to
drawing the humors toward the exterior of the body. If the jugular vein can be
opened without a ligature, as is often possible here, it will be safe to effect deriva¬
tion through its ample orifice to the external vessels of the neck. Whatever can
induce a more copious flow of the humors to the other parts of the body will doubt¬
less conduce to this purpose g;reatly; hence friction of the lower extremities, as well
as relaxation of them through immersion in warm water, is often advantageous.
Ligatures, for instance, are applied to them at the same time; which Aretaeus
orders to be placed on the arms equally, when, treating of this affection, he says:
' binding them with ligatures above the ankles and knees. Very good too are liga¬
tures on the arms toward the elbows and above the elbows toward the shoulders.” **

’*Oper. omn. Sydenhamii Cap. VII. §V.
** Celsus Lib. IV. Cap. IV.

"Vide Lib. primus Cap. VII.

124

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

Vesicants placed on these parts, stimulant cataplasms of mustard seed, etc., can
obtain successful results while they excite erysipelases and invite a supply of the
humors thither. If through these remedies the violence of the symptoms has ceased,
repellents can be made use of, for which purpose aromatics mixed with emollients
will suffice; for if the use of emollients only is persisted in too long, there would
be fear of inducing a new flux of the humors to the part, and a new attack of
inflammation, many times terminating unfortunately. This therefore will be the
most opporttme time for repellents, since by them the arteries are lightly constricted
and the blood thus is driven toward their collateral branches or corresponding veins.

XVI.

When the disease is on the decline, it will be allowable to proceed further in the
use of similar medicaments, and to associate true astringents with emollients and
aromatics, in an effort to restore the vitiated tone of the parts. These epithems are
to be used until comiJete health returns. In order for it to be restored completely,
consideration will have to be given to the patient’s streng^th, weakened and destroyed
by violent tension and excessive evacuation; and so sedulous attention should be
given to strengthening the firm parts and to correcting the unnatural dyscrasia of
the blood, lest the dropsy or intermittent fever succeed to the place of the prior
disease. The physician’s attention will be given first to the stomach; for since it
suffers the effects especially of progressive fever more than do the other viscera,
in vain shall we set to work to restore the strength of the body and do away with
the remains of the disease, unless this chylopoietic organ, cured first, is supplying
carefully prepared nutritive juices to the rest of the body. And so, first, it will be
necessary with gentle cathartics to educe the crudities accumulated during the fever,
then to restore the pristine tone of the fibre, which may best be done with aromatic
wines, iron, mineral waters, etc. Proper use even of non-natural things here
accomplishes much.

XVII.

But if the inflammation has lasted to the Sth, 7th, and even the 9th day, according
to the diverse degree of its violence; and if the tension of the parts be so great that
an increase would bring the danger of gangrene, then every effort should be made
to bring on suppuration as quickly as possible (granted that in this species of
anginal there is scarcely place for suppuration), or care should be given to reducing
the fibres to their pristine state of relaxation; and if this last succeeds as desired,
repellents, as above, should be used. But to induce suppuration, the most emollient
epithems should be applied externally in the form of cataplasms, etc., and an emol¬
lient lincture be held in the mouth and fauces as long as possible, and the same
repeated frequently. Cooling medicaments should be given internally so as to
diminish the circulation and thus allow suppuration to proceed more favorably.
When an abscess has formed, it should be opened with the small lance, or, if a timid
patient fears the instrument, a caustic can be applied. The pus having been drawn
out, the sore is to be treated with detergents, such as Aq. Hord. with Mel. Rosar.
etc. until it has consolidated. If an abscess is formed in the larynx or nearby parts,
great care must be taken that the purulent matter does not fall through the trachea
into the thoracic cavity a’"d, corroding the lungs, cause empyema. Or if pus, drawn
into the circulatory passages, is transferred to another part, the danger of abscess

ANGINA INFLAMMATORIA (DIPHTHERIA?) 125

is estimated by the virtue of the part on which it falls; and sometimes, through
metastasis to the kidneys and bladder, it escapes through the urine.**

XVIII.

Now we shall contemplate the last and most horrible state of this disease. If
inflammation of the pharynx is so great that what is ingested issues through the
nostrils, it will be necessary to supply the body with nourishment through some
other passage: for instance, diluent clysters injected into the intestines, so that,
received in the mesenteric veins and mingled with the circulating humors, they may
dilute the blood. If inflammation of the muscular membrane of the trachea and of
the muscles forming the rima glottidis becomes so violent that the voice is almost
gone, the breath drawn with great difficulty, and at the same time anxiety, dis¬
quietude, and the other symptoms mentioned above under prognosis assail, no other
way of escaping death remains to the patient placed in this distress but bronchotomy,
instituted by a prudent hand below the seat of the swelling. The method of this
section, and whatever looks towards its accomplishment safely and successfully,
has been so lucidly explained by the celebrated Sharp in his remarkable treatise on
the operations of surgery that it would be superfluous to add more concerning it here.

The disease that our two essayists have discussed is obviously diph¬
theria (Trousseau’s modification (1828) of Bretonneau’s term, diph-
theritis, 1826) though—as with other, more distinguished writers—ele¬
ments of the scarlet fever, and probably other, pictures were also included.

Oinical observation and clinical descriptions of disease had reached a
high level by the middle of the 18th century, yet this part of our two dis¬
sertations is disappointing, and, especially in Morris’, falls furthest behind
the descriptions given by Fothergill and Huxham. Good clinical descrip¬
tion had been one of the strongest features of English medicine since the
time of Sydenham and Willis, and never had it stood higher than in these
18th century days of Cheyne, Fothergill, Huxham, Pringle, Lind, and
Heberden. One wonders how much the relative inferiority of the two
theses in this aspect of the subject should be blamed on sophomoric depend¬
ence on pedantic lectures and dearth of bedside instruction. Even the sane
clinical influence, both at Leyden and Edinburgh, of Hermann Boerhaave,
medicus Europae, apparently could not overcome this handicap; though
they were written in a period of diphtheria epidemics, there is little evi¬
dence in the dissertations that either candidate had himself observed the
symptoms and lesions so rhetorically described.

In evaluating Orme’s contribution, the earlier and shorter of the two
theses, we are aided by the frankness of his opening remarks, and may

•* Oosterdyk Lib. IV. C. II. § XXIII.

126

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

accept at full value his motive for writing it—which, incidentally, illumi¬
nates the weak side of the inaugural-dissertation question. That he had
nothing new to add to the subject is apparent, and even his “ boning up
the literature ” was what one might expect after so inauspicious an intro¬
duction—only six authorities cited, four of them Ancients, one of the
16th century, and the inescapable Boerhaave for the only modem one.

But how much is Edinburgh responsible for this, how much Orme, and
how much 18th century medicine in general ? Without a thorough study
of the school’s inaugural dissertations it is impossible to say, Orme’s
candid opening remarks, and his subsequent life to his eighty-fifth year,
suggest that he did not present himself to his professors as the white hope
of Scottish medicine; but, on the other hand, where in Orme’s dissertation
is to be seen the influence of a faculty which was individually and col¬
lectively of some distinction in the medicine of the day?

Benjamin Morris achieves a better picture, but he devotes only one of
his 18 sections, and a short one at that, to the signs and symptoms of the
condition. All the characteristic features in Morris’ brief picture appear
in Fothergill’s account—but the converse does not hold. Thus, vomiting,
whether the relatively unimportant sign at onset or the grave complica¬
tion of the later stages, rigors, giddiness, delirium, escape mention; and,
stranger still, we find in neither youthful author a picture of the exudate,
slough, and ulcer that are so characteristic of the disease, though they had
been well described by Fothergill and, before him, by Zacutus, Severinus,
Mercatus and others—^authors evidently not then admitted to the olive
grove of Academe. This appears to be Morris’ worst fault of omission.
Though he apparently failed to appreciate the ominous significance of
delirium, incontinence, and singultus (included by Huxham), he did
recognize with the others that diarrhea or hemorrhages or a failing circu¬
lation were evil portents. Quite pardonably, Morris, Fothergill, and Hux- ^

ham seem not to have connected the late appearing paralyses or death ;

from heart failure with the disease of the throat.

In therapy, Morris’ out and out allopathic point of view appears in
Section 14. Congestion logically demands depletion, of course in the form
of bleeding and purging. Thus he is led to his worst fault of commission,
as both Fothergill and Huxham and others before them take definite |
stands against the routine use of both these procedures. One could specu¬
late again over the influence of English common sense versus Continental j

academic convention. It should not be overlooked that Orme also endorsed |

bleeding heartily. At least, however, Morris, like Orme, is not governed
by the doctrine of derivation and revulsion, as he recognizes that the
actual site of the bloodletting is immaterial.

ANGINA INFLAMMATORIA (DIPHTHERIA?) 127

Excessive tonus, with the same logic, for Morris requires relaxation;
but diluents, topical emollients, and mild “ laxatives ” for constipation are
more attuned to the modem ear and at least have less capacity for harm
than the weakening purgatives and bleedings—^the bloody Moloch of the
centuries. Morris seems to have passed over his third and last principle
of treatment—attenuants and repellents—in silence, and we may profitably
do likewise.

Prognostically, Morris and Orme are on sound ground, for the most
part, with Fothergill and Huxham; they recognize the evil portent of
hemorrhages, diarrhea, failing circulation and sweats; whereas the dis¬
appearance of the rash (the “ striking in of the fever ” for the uneducated
of today) appears as a bad sign of loss of tone, indicating the failure
of the attempt to discharge the peccant matter through the skin, in
Fothergill’s words.

In pleasing contrast to the way the matter is handled in the more cele¬
brated essays, are the attempts, especially Morris’, faulty though they may
be, to seek for cause and effect and to explain how the various lesions are
produced. Etiology, to be sure—Orme’s “ remote causes ”—is dismissed
by them in a few lines that are curiously alike (the effect of a fever of
earlier origin, cold drinks, cold winds, long continued outcries, singing,
playing of trumpets, and, for Orme, “ a certain morbid constitution of
the air”). Apparently, neither knew that Fothergill, a few years earlier,
had achieved as the cause “ a putrid vims, or miasma sui generis, intro¬
duced into the habit by contagion, principally by means of the breath of
the person effected.” On the other hand, pathogenesis (” causes ” to
them) occupies most of Morris’ Sects. 6 to 9; and whereas again little
valid can be expected in view of the current theories of disease that still
reflected the humoral theory and the strictus et laxus of the ancients,
nevertheless some of Morris’ explanations satisfy, and his mere indication
<rf the need for explanation is in itself significant. With proper caution
against reading into statements an interpretation that only becomes possi¬
ble in the light of later discoveries, we find that Morris’ approach did pay
him some dividends. Thus, the rigidity of the swollen inflamed soft palate
explains the regurgitation of the food into the nose (Sect. 9); the swol¬
len larynx and trachea explain the painful, laborious respiration; the
inflamed pharynx, the dysphagia; pus forced into the circulation, by
metastasis, caused “ phrenitis ” or abscess of the lung (Sect. 11).

The statement (in Sect. 7) that in acute inflammation the liquors con¬
tained in the vessels are so thickened that the vessels become impassable

128

EDWARD B. KRUMBHAAR AND W. B. MCDANIEL, 2D

is in accord with the best modern concepts; but the admiration thus
aroused is checked by the reference in the same sentence to the orifices of
these vessels “ through which nature is accustomed to pour the mucous
humor adapted to lubricating the fauces.”

The two essays end with two happy touches—^the recommendation of
the use of nutrient enemas where swallowing is obstructed, and of
‘‘bronchotomy ” in desperate cases of suffocation. We have searched in
vain for these recommendations in Fothergill and Huxham. But lest one
should prematurely conclude that here the essayists had contributed some¬
thing original and of importance, it should be stated that both procedures
had been practiced centuries earlier. Clysters, of course, were long one
of the favorite modes of treatment, and were said to have been used by
Avicenna as a way of introducing nourishment. Tracheotomy, which
like so many other experimental procedures, was used by Galen, not only
was “ so lucidly explained by the celebrated Sharp,” but appeared now
and then elsewhere in 17th and 18th century literature; the mention of it
by both Orme and Morris is sufficient indication that the operation was
well known.

In comparing these two theses, it is well to bear in mind that one of the
candidates, the 23 year old Scot, was pursuing his studies on his native
heath, whereas the other, a 25 year old American, had journeyed far and
long to study in alien surroundings, under masters who spoke a tongue
alien to him. We have presented evidence, furthermore, that the American
had received excellent preliminary instruction before submitting himself
to the final studies leading to a degree. In these circumstances, regard¬
less of the comparative merits of the instruction offered in the two schools,
it should not be surprising to find Morris’ thesis the more mature of the
two. Orme’s can be set down as having accomplished in quite respectable
academic fashion the limited aim that he frankly admits. Morris’ disserta¬
tion, on the other hand, deserves praise as a worth while piece of work,
giving, as it does, as satisfactory a picture of diphtheria, with one or two
exceptions, as could be expected from an inaug^ural dissertation in its day.
In several respects, to be sure, it is inferior to the longer, professional
accounts of his elders Fothergill and Huxham, both based on extended
clinical experience; in the mention of tracheotomy, both he and Orme
are in advance of the more celebrated writers.

These two theses certainly had no effect on the medical world’s knowl¬
edge of diphtheria; conversely, they illustrate once again the slowness with
which even the greatest of the medical schools opened their doors to extra-

ANGINA INFLAMMATORIA (DIPHTHERIA?)

129

academic developments. Together, they offer interesting comparative
material for a study of the relationship between academic teaching and the
general status of medicine in the mid-18th century. It is not being too
harsh perhaps to recall the old saying (still and always to be true in the
larger sense) that one’s education begins on the day he leaves the
university.

MEDICINA ABORIGEN PERUANA

JUAN B. LASTRES

Buena hora es esta, hora de critica, en que debemos revisar y analizar
la medicina aborigen peruana. La ola de inquietud y de zozobra que agita
al Orbe, no es obice para que contemplemos serenamente el pasado. Siem-
pre la historia ha sido y es motivo de ensenanzas, y el entusiasmo acrece
en este sentido, cuando penetramos en la medicina aborigen e interrogamos
todos los restos de las antiguas civilizaciones. Hace algunos ahos, vengo
estudiando con renovado afan, esta medicina; al principio con extrema
admiracion, como pasa con todo aquel que recien se inicia en una dis-
ciplina. Luego viene la fase reflexiva, la comparacion y la sintesis final,
vale decir la critica. Tema sumamente cautivante, sobre el que se ha
escrito mucho y se ha dicho poco. Porque casi todos los investigadores,
se han concentrado a repetir hasta el cansancio la misma cantilena, de que
todo aquello fue grandioso, sin detenerse a analizar cada delicado problema,
de los muchos que plantea la medicina aborigen. Hace pocos anos, queria
plantar una lanza en este espinoso problema, y ahora se me presenta esta
posibilidad. Es por eso que quiero dejar sentados alg^unos puntos de vista,
de los muchos que he madurado en el curso de diez anos.

Se pensara por este corto exordio, que mi actitud es un tanto iconoclasta
en cuanto al planteamiento del problema. Pero asi tiene que ser, porque
no es posible en el estado actual de la ciencia, de hacer diagnosticos y
escribir monografias, como se ha hecho en anterior ocasion, a base de unos
pobres datos, unas cuantas leyendas 6 la vista e interpretacion antojadiza
de un huaco, el cual suscita diferentes diagnosticos, segun sea el color del
cristal con que se mire. Resulta curioso y paradojico, que un mismo huaco
ha servido para fundamentar los diagnosticos, extremadamente variados.
de Uta, lepra y sifilis y seguramente otros mas.

Se ha escrito mucho y se ha interpretado poco. Hace algunos anos,
estaba de moda incursionar sobre medicina aborigen y sobre ceramica.
Pocas fuentes y mucha literatura. Estando en Paris en 1939, aparecio
un libro de Raoul D’Harcourt, “ La medecine dans I’ancien Perou,” libro
elegantemente impreso, pero con pobre documentacion. Tiene de bueno
que situa la medicina aborigen, en el grupo de las medicinas primitivas;
y es asi a mi manera de ver, como debe situarsele. En cambio incurre en
error al incursionar en paleo-patologia 6 al interpretar los ceramics
incaicos.

130

MEDICINA ABORIGEN PERUANA

131

Podemos decir que existe una verdadera deformacion de la medicina
indigena, no solo en lo que atane a los estudios hechos por profesionales
6 aficionados, sino en las mismas tendencias pre-concebidas de cada ob>
servador, de un lado tenemos a los indigenistas o la tendencia indigenista,
quienes ven todo favorable al aborigen, ya sea utilizando preferencialmente
los cronistas que senalan las costumbres y la misma civilizacion imperial,
con un sentido admirativo, ya interpretandolo todo, con el afan de exaltar
sus practicas primitivas. El mas grande de nuestros historiadores medicos,
Valdizin, incurre en este pecado. Su mismo libro sobre medicina popular
es una loa a todos los procedimientos curativos de los indios. I en la
introduccion de su magnifico Diccionario de Medicina, estampa este con-
ccpto: . no le fue posible a Espana poner validos empenos en servicio

de la obra de recoger la herencia de cultura de la raza conquistada . . .
encomendandose esta actividad al celo de Francisco de Toledo.” Y abrma
que si esta averiguacion se hubiera hecho antes, “ hubiese dado mejores
y mas provechosos frutos. . . En su obra “ La Facultad de Medicina
de Lima,” copiando a David Matto, dice: “ Los conquistadores, hombres
dispuestos en todo momento a morir 6 matar, apenas se cuidaron de
apreciar el grado de adelanto a que llegara el arte de curar en la tierra
conquistada. Tampoco bubo, entre aquella falange de heroes, alguien que
tuviese la preparacion necesaria para poder discernir de lo poquisimo que
los indigenas, pwr reserva justificada, quisieron suministrarles en materia
de medicina.”

Otros autores repiten insistentemente: existian ” Habiles cirujanos ”
(jue practicaban las trepanaciones, operacion que aparece casi como la unica
de importancia y de maxima importancia, aislada, en medio de una pe-
quena cirugia primitiva. Y hay quien llega a afirmar, para detrimento de
nuestra era modema, que los resultados que obtuvieron fueron “ tan
buenos o superiores a las. tecnicas modernas.” Dietschy, interpretando
erroneamente a Guaman Poma, dice que “ En las grandes ciudades
existian verdaderos hospitales que admitian a los enanos, jorobados e
individuos con labio leprino,” y lo linico que expresa el citado cronista,
que yo he estudiado exhaustivamente, es que los enfermos eran colocados
en ciertas calles: “ Quarta vecita a esta calle de la quarta son llamados—
nausa cuna ciegas—, hancaco zas upamuda-ninay incoc tollidas, . . . , ”
etc. Y por fin, no faltan autores. que con admiracion hiperbolica, dicen
que los cirujanos “ poseian la vision del aguila, el corazon del leon y las
manos de una dama,” seres sobrenaturales, sobre los que guardan silencio
reprobable los cronistas; y aun sobre la misma trepanacion, de la cual el
admirativo Garcilaso, dice que fue practicada por mano empirica en un

132

JUAN B. LASTRES

soldado Don Francisco de la Pena, anadiendo ironicamente “ por na-
turaleza de Pena y no por apelHdo,” a quien le habian dado tres “ cuchil-
ladas en la mollera . . . con el casco quebrado,” el cual fue quitado por
un cirujano, curando luego el herido “ sin calentura, ni otro accidente.”
Y en cambio, sobre la trepanacion que practicaban sus antepasados, no nos
dice ni palabra.

Veamos ahora el lado espanol. Espana marchaba a su apogeo. Era el
siglo de oro o mejor la “ Era de oro,” como dice Krenger. La Universidad
de Salamanca, fundada hacia el siglo XIII, estaba en su esplendor y a
ella concurrian, como a la nueva Meca, todos los intelectuales que querian
profundizar en medicina. Hacia 1566, tenia 70 profesores y 7,800 es-
tudiantes. Valladolid, Alcala de Henares, y otras Escuelas Medicas,
representaban igualmente el saber del medioevo, senalandose por notables
adelantos en medicina. Esta medicina, como afirma Krenger, “ asumio
en un principio funciones transmisoras y transformadoras. Los metodos
curativos practicados por los moriscos vencidos y expulsados de Europa,
fueron adoptados y perfeccionados a traves de un espiritu europeo; se
trataba aqui de gran parte de conocimientos de la antigua terapeutica que
habian sido arabizados.” Y esta accion terapeutica de los medicos
espaholes de este siglo, es tambien influida por la vida palaciega y guerrera
de la epoca. Laguna, el gran anatomico, Amusco, Aguero, Mercado,
Valles, Cristobal de la Vega, Monardes, Montana de Monserrat, Arceo,
Fragoso, Daza Chacon y otros muchos, fueron altos exponentes medicos
de aquella gloriosa epoca. Pero tambien ella se refleja en nuestra America.
A la sombra. de estos grandes galenos, se educan los futuros protomedicos
y los medicos bohemios, que vendran a ganar la America. Y justo es
consig^ar este dato, en defensa de Espana y de su cultura; y poco despues,
el noble afan de gobernantes y protomedicos, por dar oficialidad a los
estudios universitarios y a los de medicina en particular; empenos que
culminaron en la creacion de nuestra Alma Mater, la primera de America.

La medicina incaica hay que situarla a mi manera de ver, en su verda-
dero piano. No es posible seg^uir diciendo en el momento presente, que
aquello fue un arte supremo y una ciencia acabada. Hay que deducir el
estado de la medicina, de la civilizacidn misma. Y convenir con Riva
Aguero, que “ El imperio incaico no es un blando idilio con musica
galante.” Hay que restituirlo a su clima verdadero; y compararlo con
cuidado (porque sin comparacion no puede haber ciencia, ni perspectiva,
ni clasihcacidn, ni conocimiento alguno), con los imperios orientates
primitivos y barbaros, en particular con el Egipto faraonico y la China
arcaica, que se presentan como sus arquetipos genuinos y fraternales, por

MEDICINA ABORIGEN PERUANA

133

espontanea coincidencia. Esos son sus remotos hermanos mayores, que
le Ilevan respectivamente, en muy moderada cronologia, 4000 y 2.500 anos
de ventaja. El Tawantisuyo, fue para el mismo historiador, “ una China
joven destruida en los primeros grades de su evolucion.” Si esto es asi
en materia de civilizacion. es logico pensar que pasaria lo mismo en medi-
cina. “ La medicina de un pueblo da la medida de su capacidad cerebral,
como la medicina de un siglo, nos ensena sobre su desarrollo intelectual,”
ha dicho L. Barbillon. Y la medicina del Imperio Incaico, no tiene porque
apartarse de su civilizacion. Y por tanto tiene que ser primitiva, como
lo es esta. Hay sacrificios humanos, ritos funerarios, embriaguez con¬
siderable, fiestas de purificacion, ayunos y procesiones para ahuyentar los
demonios, sacerdotes, magos, taumaturgos y curanderos, que ejercitan el
masaje, la succion y la magia externa, etc. La Citua, aquella fiesta des-
tinada a ahuyentar las enfermedades y la purificacion del cuerpo y con-
servacion de la salud, tiene su equivalente en el No chino, como sostiene
Riva Agiiero. La practica de la momificacion, el uso de los trofeos hu¬
manos, la predileccion por los enanos, deformes y jorobados, que danzan
delante del monarca, asi como los ciegos, que son socorridos por la caridad
ptiblica. I No es esto evidentemente, medicina primitiva, como la ejerci-
taron los aztecas, hermanos de continente y de civilizacion de los Incas ?

Convengamos con Riva Agiiero, que el escritor y critico sensato. “ ha
de ser equidistante del indigenismo exclusivo y ciego y del europeismo
anti-incaico.” Hay que medir las practicas de la medicina en esa remota
epoca, con los mismos cartabones, con que se mide y aprecia la medicina
de otros pueblos primitivos. No con los de la politica ni con los de los
partidismos sectarios, sino con los que dicta la critica serena de los hechos
y dar el justo valor a las fuentes documentales de que disponemos. Es
facil caer en exclusivismos. Cuando el estudiante 6 el medico, comienza
a investigar sobre medicina aborigen, la primera actitud al contemplar los
craneos trepanados, es admiracion; admiracion hiperbolica. Y facilmente
se llega, topando solo con las fuentas indigenas, al mancismo por ejemplo,
a admirar todo lo incaico, sin recurrir a mayor inventario, ni a mejor
critica. Luego viene esta; y dirigimos la mirada hacia la Espana inmortal,
aquella que nos lego la lengua y su genio secular. Y caemos en el vicio
opuesto, en la denigracion de todo lo indigena. Situemonos, pues, en un
piano medio, en un terreno eclectico; y asi no caeremos en admiraciones in-
fantiles o en detracciones inutiles. Y creo que del estudio sereno de cada
fuente documental, y de cada cronista, conforme hemos comenzado ya a
hacerlo; de la critica de las obras de Garcilaso y Guaman Poma y de los
demas cronistas e historiadores, se pueden obtener datos de primera mano.

134

JUAN B. LASTRES

Dar a la ceramica, el folklore, a los huesos y momias el valor que cada
uno tiene, y asi habremos contribuido a formar el edificio de la medicina
incaica, que hasta este momento esta por hacerse.

i El lenguaje como medio de hacer diagnosticos retrospectivos ? y fun-
dar asi una facil paleo-patologia. He aqui una manera comoda que ban
utilizado todos los investigadores que ban buceado sobre medicina incaica.
Yo me pregunto Pero ese quechua, casi academico y esas voces, que
denotan sig^os 6 enfermedades, no ban sido tomadas de los vocabularies
corrientes de la lengua queebua? Estos vocabularios, a la cabeza de los
cuales esta el de Bertonio, ban sido compuestos en epoca muy posterior
a la conquista, y por tanto se ban agregado muebas voces y otras ban sido
tomadas directamente del espanol. “ A nada se parece,” dice mi Maestro
el gran Maranon, “ el idioma, como a un rio copioso que recibe sin cesar la
suma de infinites afluentes y, a veces, el aporte torrencial de sus avenidas.
Quierase 6 no, todo se convierte en patrimonio legitimo del caudal mayor
y hay que aceptarlo hasta cuando las aguas que afluyen son aguas re-
vueltas, que momentaneamente enturbian la limpidez del curso original.”
Y es muy comodo, tomar el Vocabulario de la lengua quechua y comenzar
a examinar friamente en el, los terminos que indiquen una enfermedad
o un procedimiento medico, 6 un organo. Pero a una pequena observacion
notamos que ellos ban sido adulterados o mejor tornados de analogas
palabras espanolas. Se hace duro creer que los curanderos indigenas, que
no abrian el vientre, sino para hacer sacrificios, conocieron con tanta
perfeccion los organos internos, como asevera Olano, diferenciando al
atlas, del axis, los organos de los sentidos, etc. Creo que la contribucion
que presta el idioma es grande; pero hay que convenir que muchos ter¬
minos no se usaban en la primitividad 6 tenian un significado diferente.
Buena ayuda presta en este sentido, la Cronica de Guaman Poma, que
tiene mucho de medicina y sus terminos originales y que con el Profesor
J. M. B. Farfan, nos hemos esforzado en interpretar, y en que el autor
indio, aporta datos linguisticos, aunque esta tocado de bilinguismo, de
primera mano, para establecer el folklore. Para muestra basta el verso
6 cancion guerrera adjunto:

Aucap umanuan upyason, El craneo del traidor, beberemos en el
Quironta ualcarisun, Llevaremos sus dientes como collar

tullunuan pincullusum, De sus huesos haremos flautas

caranpi tinyacusun, De su piel haremos un tambor

taquecusun. Entonces bailaremos.

MEDICINA ABORIGEN PERUANA

135

cancion llena de belleza tragica, pero que nos muestra perentoriamente los
sacriBcios y los amuletos que se empleaban en aquella gentilidad.

A la ceramica, se le pueden oponer serias objeciones en cuanto a
la interpretacion de sus modelos. Precisamente, acaba de aparecer bajo
mi direccion, un Album de Representaciones patologicas, cuya sola pre-
sentacion evidencia el anterior acerto. La mayoria de los especimenes en
el representados, forman parte del rico acervo cultural del Museo National
de Arqueologia de Lima. Indudablemente que faltan las demas colecciones
existentes en Museos y Colecciones particulares, pero hay que comenzar
con poco, presentar el material y despues interpretarlo.

El arte de la ceramica, con el elevado grado de perfeccion que alcanzo
desde epocas remotisimas en nuestro suelo, constituye fuente arqueologica
de valor inapreciable. El estilo muchik, principalmente escultorico y repre-
sentativo, es en el que se encuentran las piezas mas perfectas desde el punto
de vista anatomico-artistico. Y a el se han dirigido las miradas de medicos
y psicologos, que han querido desentranar la deformation organica y el
fino matiz psicologico que se perciben en los rostros. La perfeccion mas
notable en este arte, lo constituyen sin duda los llamados Wakos retratos.

" Solo entre los mochicas hallamos la reproduccion artistica del individuo,
y el alfarero del norte, logra no solo traducir fielmente los caracteres
raciales y personales de sus modelos, sino interpreta tambien con pleno
ocito las expresiones habituales o las momentaneas de ellos.” La per¬
feccion que alcanzo el artista muchik en la representacion del rostro'
humano, desde el punto de vista cientifico, fue notable al decir de Urteaga;
igual asercion hacen Barber y Tamayo, y lo confirman, a traves del tiempo,
la inmutabilidad de la linea, lo impecable de la reproduccion de la na-
turaleza y la habil preparacion del modelo en si.

El estudio semiologico de la facies a traves de la ceramica, es por demas
interesante. Y creo con este estudio cHnico-semiologico, establecer retro-
spectivamente, algunas rnodalidades de la patologia del Incario, lo que
podria llamarse una paleo-patologia. Asi tenemos en las piezas repre-
sentadas por los muchiks, las deformaciones del rostro. Un trabajo sobre
mimica facial en los huacos, se podria componer, utilizando los variados
modelos que expresan los distintos estados de animo. Aqui se revela al
artista como un fino psicologo. El dolor, la reflexion, la indiferencia, la
atencion, el desden, son interpretados fielmente en la arcilla. Gran parte
de la semiologia psiquiatrica ostensible en la mimica, como la expresion
externa de un estado particular de animo, esta igualmente caracterizado en

136

JUAN B. LASTRES

la ceramica. Aparte el factor funcional, encontramos a la busqueda minu-
ciosa, otras facies tipicas, que por si solas bastan para hacer un diagnostico.
La facies edematosa se descubre en numerosos modelos. La uniforme-
mente edematosa, con fuerte infiltracion de los parpados, y con abota-
gamiento general de la cara, que traduce un sufrimiento renal o cardiaco.
En un huaco, la hemos encontrado en la mitad de la cara, coincidente con
una paralisis facial izquierda de tipo periferico. Por lo menos, en un par
de huacos de la ceramica muchik, se logra. identificar la facies acro-
megalica. En un huaco del Museo de Chiclin, se puede observar bien la
facies basedowiana. Si seguimos nuestra busqueda, encontramos en
muchos la facies gerodermica,’ por distrofia adiposo-genital. Luego las
diversas formas de paralisis facial, sobre todo de tipo periferico. Los
ciegos en su infinita variedad. La conjuntivitis y un tumor del ojo.

Mientras que las perdidas de sustancia observadas de continuo en la
ceramica: mutilaciones de labios, nariz y pie, sobre todo izquierdo, y que
yo reproduzco en mi Album, son para Velez Lopez verdaderas mutila¬
ciones por castigos, estando siempre la magnitud de la mutilacion, en razon
directa con el grado de la falta; para Tamayo, estas mismas perdidas de
sustancia, son otras tantas lesiones debidas a la uta 6 leishmaniasis dermica.

Y los mismos huacos, para Lehmann-Nitsche, representan la lepra.
i Como pues ponernos de acuerdo con tantos diagnosticos ?

Los alfareros del antiguo Peru, como artistas fieles de la naturaleza,
ban debido limitarse a copiar las facciones, y lo han debido hacer segura-
mente, sin prejuicios y casi empiricamente, desde el punto de vista
estrictamente anatomico, reproduciendo ya un rostro normal, ya uno
patologico, deformado por la enfermedad. Y este casi empirismo de los
artistas, nos sirve en el modelo, de valioso document© para establecer la
anatomia de la cara y la deformacion producida por la enfermedad. o el
diagnostico retrospectivo. No podemos tampoco pedir a la ceramica
diagnosticos de finura. Hay que conceder a las piezas, valores relatives
para el diagnostico medico. No es posible, como pretenden algunos, funda-
mentar diagnosticos de suma precision, valiendose de la desviacion de
una linea o la abolicion de una eminencia. “ Todo lo representado en ella,
tiene un sentido simbolico, era un lenguaje, no un simple y superficial
adorno,” dice acertadamente Valcarcel. El primitivo, afirma Worringer,
“se crea simbolos de necesidad en las formas geometricas o estereo-
metricas. Aturdido y aterrado por la vida, busca lo inanime porque en
ello ve eliminada la inquietud del devenir y afirmada la fijeza perdurable.”

Y esta forma de escribir de los primitivos, que quisieron que en la arcilla
se immortalizara su emocion artistica, viene hoy a nuestras manos.

MEDICINA ABORIGEN PERUANA

137

para servirnos a la medicina. La ceramica nos dice que aqui hay un
enano acondroplasico, mas alia un jorobado, luego una paralisis facial,
un labio leporine, horadaciones, mutilaciones, deformaciones, tatuajes,
facies tipica de enfermedad, etc. Pero de alii a establecer diagnosticos de
sifilis, tuberculosis, cutanea, lepra, etc., va mucho trecho. Aun hoy mismo,
con los metodos de laboratorio modernos que poseemos, nos es muy dificil
hacer estos diagnosticos. Solo debemos pedirle a la ceramica, lo que ella
nos puede dar y este poco, hay que someterlo a un riguroso analisis. La
mayor parte de las interpretaciones que se han hecho de los vasos, no pasan
de ser elucubraciones imaginativas, entusiasmos u obseciones de los in-
vestigadores. Un mismo huaco, ha servido para hacer dos o tres diag¬
nosticos y sin embargo, la pieza de barro, continua siendo la misma. In-
vestigador notable hay que sostiene corresponder a lepra, casi todes las
mutilaciones observadas en la ceramica; y otro que la sifilis sea la re-
sponsable, etc.

Concluimos que la ceramica es una fuente historica de valor relativo
para reconstruir la medicina aborigen y en especial la paleo-patologia.

El folklore tambien es una fuente para la reconstruccion de la vida y
costumbres de los aborigenes. Pero hay que marchar con tiento, como en
toda especulacion historica. Hay costumbres que se han conservado in-
columes en el curso de las centurias y estudiandolas, se puede saber a
ciencia cierta, como fue aquello en la primitividad. Poblaciones hay
actualmente en el Peru, como Salas al interior del Departamento de Lam-
bayeque, que se le senala como un pueblo integramente de “ brujos,” y en
que se puede estudiar la brujeria con todas sus practicas y poder asegurar
que lo que pasa ahora, sucedio tambien hace siglos. “ La leyenda popular,”
ha dicho Garrison, “ es una unidad esencial. La inteligencia del hombre
salvaje, en sus pateticos esfuerzos para establecer los sistemas eticos y
religiosos que sirven de guia moral y espiritual o para embellecer el aspecto
vulgar de la vida con el romanticismo y la poesia, ha recorrido siempre
las lineas de menor resistencia, sigpjiendo siempre las mismas etapas
progresivas.” Lo que pasa actualmente en Salas, pasa igualmente en otras
poblaciones de la sierra. Pero en cambio, hay otros centros, que las
leyendas se han ido modificando por la adicion de lo extranjero, y entonces
ya no resulta bien la busqueda.

Los estudios de Folklore hoy por el mundo, van adquiriendo enorme
importancia. En el Peru, el elemento aborigen ofrece gran campo a la
especulacion folklorica. El indio, obedeciendo ya-al comunismo agrario
elevado y completo, como dice Sarmiento de Gamboa, en tiempo del

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Tawantinsuyo, o al ostracismo a que le condeno la conquista, conserva
incolume la fuerza de la tradicion. La idolatria del indigena, formaba casi
todo su sistema creyente. Sendos volumenes, principalmente debidos a
pluma de misioneros que recorrian el territorio, para llevar la religion a
sus confines, nos ofrecen muestra y descripciones de sus divcrsas formas.
AlH estan las obras clasicas de Cristobal de la Molina, Morua, Arriaga,
Acosta, y otros en donde se pueden estudiar las fabulas, ritos, supersticiones
y leyendas de los Incas. Son documentos de primera mano, pues que
fueron escritos a raiz de la conquista. Sobre sus paginas y entre lineas,
debe entresacarse el folklore, y luego interpretar y cote jar sus resultados.
para darles el valor de fuente historica.

Ya entre nosotros se ha utilizado la fuerza de la tradicion por dos in-
vestigadores, los Drs. Valdizan y A. Maldonado.—Valdizan fue un in¬
digenista convencido, que exalto la pasada grandeza de la raza y sono
seguramente en su redencion. De alii su aficion entusiasta por los estudios
folkloricos, y de alii su empeno por mostrar las excelsitudes de muchos
procedimientos primitivos, El indio es una esfinge de dos caras, dice
Lopez Albujar. Con la una mira el pasado, con la otra. el provenir. Pero
es principalmente su vida interior, la que tiene rico colorido. Valdizan
dice de ella: “ Esta subconciencia del indio vive vida intensa el pasado
de la raza, aparecen en ella, como al conjuro de practica taumaturgica
evocadora, los viejos mitos de los incas: el Padre Sol, la Madre Tierra,
el divinizado Puma, y en torno a estos nucleus miticos, aparecen sus
pintorescos derivados, algunos de los cuales ya ostentan la huella de la
predicacion evangelica en tierras de America; al numero de estos derivados
pertenecen el Machu, el Kepke, el Huamani y el Auquillo, mitos de los
quechuas; el Lari Lari y el Achachilla, mitos de los aymaras.” Muchos
de estos mitos perviven actualmente, con las caracteristicas de hace siglos.
Los indios idolatras y supersticiosos, que ante el ichuri confesaban sus
pecados, que se los purificaban en los ayunos y penitencias publicas 6 en
la clasica fiesta de la Citua, o arrojando al aire un punado de arena, tenian
la creencia del origen sobrenatural de sus males; y para curarlos, habia
que aplacar la colera de los dioses de su gentilidad. Los Callagualas
actuales, o curanderos, son depositaries del arte de sus antepasados los
Kollanas, curanderos y brujos, que ejercian en los departamentos del Sur
del Peru y en Bolivia. Yo me imagine a los Collagualas herederos directos
de los pontifices o hechiceros que nos describe Guaman Poma y aim de
los mismos Camasc cas a Soncoyyoc y los Jampecc, practices del Imperio.
Su misma indumentaria, reproducida en la citada obra, de Guaman Poma,
los asemeja enormemente.

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139

Algunas laminas de la obra de Guaman Poma y las descripciones sobre
hechicerias, son muy importantes a considerar. Bien es verdad, que falta
un gran renglon, el folklore botanico. Abstraido el autor en la contem-
placion pol'itica y costumbrista del panorama indiano, se preocupo poco
en darnos a conocer las yerbas y su aplicacion en la medicina popular.
Solamente se detiene momentaneamente para decirnos cuatro palabras
sobre la coca, el maiz, la papa, el olluco, quinua, arracacha, frijol, y algunos
purgantes (lupinus) ; 6 de la administracion de las “ yeruas ” por los
curanderos indios, ya que a estos les concede la cualidad de ser grandes
herbolarios, rodeados de mariposas nocturnas, escorpiones, mochuelos,
fantasmas y aparecidos. El indio que nos describe Guaman Poma es
profundamente triste. Esta oprimido y aherrojado de su patrimonio.
Pero esta dotado de gran espiritualidad. Su vida se desliza entre un con¬
tinue llanto por el recuerdo de la libertad perdida; “ Oh gran senor 1;
hasta cuando clamare, sin que me respondas?.” Trae una bella descripcion
de las hechicerias y de los hechiceros. Los “muy malos,” que daban
venenos y producian el envenenamiento (hanpicoc). Otros que unian a
hombres y mujeres (tinquichi). Otros que echan maldiciones, soplando
con maiz molido. Otros que utilizan la ponzona del sapo; o que toman
un hilo torcido, poniendolo en los caminos por donde ban de pasar sus
enemigos, etc. etc.

Toda la medicina aborigen es casi una medicina magica, en que las
practicas taumaturgicas ocupan el primer lugar. Muchos autores, como
Acosta, Molina, Arriaga y otros, nos hablan de escenas de simulacion.
Despues de aplicar unciones con grasa a la superficie, en la piel (esto se
puede observar en algunos huacos), los curanderos masajeaban el cuerpo
del enfermo, haciendole creer “ en succionando la parte enferma,” que le
sacaban sangre, pequenas piedras, etc., y que ellos mostraban a sus clientes.
De esto trae una bella descripcion el Padre Cobo, en que el enfermo lo
colocaban en un cuarto especial, el cual era purificado soplando en sus
paredes harina de maiz y mojando los muros con agua y harina. Luego,
“ por ilusion y artificios del demonio, era arrebatado en un profundo sueno
y extasis,” durante el cual, los curanderos hacian como que le abrian el
vientre y le extraian culebras, sapos y otros animales, los que sometian
al fuego y de esta manera purificaban al enfermo. Brillante descripcion
de una especie de sueno hipnotico. Utilizaban los artificios de la tauma-
turgia, para curar psicoterapicamente.

Los practicos del incanato, el Jampecc de Olano, o los Camasccas y
Soncoyyoc, tenian idea vaga del contagio, al que denominaban ticrapu.
Exageradamente, Olano atribuye a estos curanderos, “ alma de medico.

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JUAN B. LASTRES

reiinada en grade sublime.” Les atribuye conocimientos para hacer el
diagnostico y la terapeutica, o sea el ticrapu y el uyhuachi, o sea un pro-
cedimiento por el que se hace creer a los enfermos, ser posible el descubri-
miento de sus males, haciendo que estos se reproduzcan en animales,
como ranas, cuis, etc. De alii naceria para el y en verdad que asi lo es,
una especie de curacion por psicoterapia.

Estoy de acuerdo en contemplar asi al curandero primitive, ya sea
Camascca, Machi, Shaman. Ejercitaron todos ellos su arte de una manera
empirica y dando a las curaciones medicas, un caracter magico. Es la
taumaturgia puesta al servicio de los enfermos.

Vuelvo a insistir que al examinar el folklore del pueblo aborigen
peruano, hay que marchar con cautela, para asi no caer en interpretaciones
antojadizas. Con todo, me parece fuente de primera linea para reconstruir
la medicina primitiva, pues que los conocimientos, buenos 6 males, han
quedado depositados en la memoria de los pueblos, en el alma popular y
representan su verdadera sabiduria. Mientras que la ceramica es una
fuente estatica, el folklore es una fuente dinamica que interroga la men-
talidad primitiva, vibrando en su ambiente.

Una forma moderna de analizar la medicina aborigen, es el estudio
exhaustive de cada cronista. Ya hemos comenzado esta busqueda, estu-
diando a Garcilaso y Guaman Poma.

Examinemos suscintamente a Garcilaso. En sus obras hallamos muchos
dates para reconstruir el pasado medico. En su autor se unen armonica-
mente dos razas para darle caracteristicas de superioridad intelectual.
Los hombres blancos, barbudos, ag^erridos, van a mezclar su sangre con
las princesas indias descendientes de Manco Capac. Asi resultara fruto
de este mestizaje, el criollo, con caracteristicas raciales un tanto diferentes
a las de sus progenitores y con psiquismo muchas veces superior al de
ambos. Es la americanizacion biologica del inmigrante, como dice Rojas
en su ” Eurindia.” El tipo fisico de la raza se regionaliza, se adapta
biologicamente, cambia el pig^ento del dermis y adquiere caracteristicas
psiquicas propias.

Una facultad psiquica de admirar en el Inca Garcilaso, es su prodigiosa
memoria. Se sabe que salio del Cuzco en 1560, a los 21 anos. Que siendo
nino, habia escuchado de labios de sus familiares maternos, los relatos de
los origenes del Imperio; y que en la declinacion de su vida, esos mismos
recuerdos le sirvieron para componer ese magnifico poema en prosa, los
” Comentarios Reales.” Asi, viven en su memoria, con toda nitidez, los
relatos escuchados en la infancia a su tio abuelo, el Inca Cusi Huallpa

MEDICINA ABORIGEN PERUANA

141

6 a su misma madre, la princesa imperial Chimpu Ocllo. Los hechos de
armas y las conquistas del Imperio, eran motive de delectacion espiritual
para el imaginative Garcilaso. “ Entonces,” dice Riva Aguero, “ se
engolfaba lenta y dulcemente en las remembranzas, como quien, despues
de prolongada ausencia, remonta el manso curso del rio native.” Juste
sera reconocer en Garcilaso, la excelsitud de esta cualidad intelectual.
Los relates de la fundacion del Imperio, la aparicion de los presagios que
anunciaban su derrumbe inminente, los secretes celosamente guardados
de las propiedades de las plantas medicinales, la descripcion de los sun-
tuosos temples dedicados al Sol, las guerras civiles, etc.; todo en sus mas
minimos detalles, nos lo va puntualizando. Y al recordar los gloriosos
hechos de armas de los de su imperial sangre, misticamente exclama:
“ Cuanto se perdio aquel Imperio, cuando saquearon sus mas preciadas
riquezas y derribaron por el suelo sus mayores majestades. ... Y en la
memoria del bien perdido, trocosenos el reinar en vasallaje. . . .”

Los “ Comentarios Reales,” son sin duda su mejor obra literaria.
Gozaron de una autoridad omnimoda durante siglos. Fue la obligada
obra de consulta, para todos aquellos que se dedicaban a investigar los
origenes y las caracteristicas del Imperio del Tawantinsuyo. Despues la
diatriba desorbitada, se ensano con el autor, hasta negarle toda autoridad
historica. Hoy asistimos felizmente a su rehabilitacion. Del cotejo que
se ha efectuado con las numerosas cronicas de indias, resultan todas ellas
concordantes con Garcilaso, de lo cual se desprende la veracidad historica
y geografica de sus Comentarios. Pero si mientras en los demas escritores,
encontramos la descripcion ordenada y detallista 6 el hacinamiento croni-
queril de los diversos hechos en ellas tratados, en Garcilaso habla el senti-
miento y el afecto. Sentimos vivir palpitante el Imperio, en su “ animo,
hablan los profundos instintos adivinadores del misterio de las razas y
las estirpes. En el sentimos plenamente la eterna dulzura de nuestra
patria, la mansedumbre de sus vicunas, la agreste apacibilidad de sus
sierras y la molicie de sus costenos oasis,” dice Riva Aguero. Asistimos
a la reconstruccion de este Imperio semi-patrialcal, con sus instituciones
primitivas y el reparto equitativo de sus tierras, en una especie de comu-
nismo agrario, con sus idolatrias y sus supersticiones; y con su medicina
primitiva, dominada principalmente por la magia. Garcilaso es un maestro
en la descripcion del pueblo aborigen. En su obra va puntualizando las
variadas leyendas y mitos, la idolatria, la religion, las costumbres, datos
que nos sirven antropo-psicologicamente, para analizar las caracteristicas
de aquel pueblo. Nadie mejor que Riva Aguero, ha analizado severamente
al hombre y a la obra. ” Son las suyas esas verdades generales, patrimonio

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JUAN B. LASTRES

de los historiadores con alma de poetas, que se equivocan y yerran en lo
accesorio, pero que salvan y traducen lo esencial. Y es la entrana misma
del sentimiento peruano, ese aire de pastoral majestuosa que palpita en
sus paginas y que acaba en el estallido de una desgarradora tragedia, ese
velo de gracia ingenua tendido sobre el espanto de las catastrofes, lo dulce
junto a lo terrible, la flor humilde junto al estruendoso precipicio, la
sonrisa resignada y melancolica que se diluye en las lagrimas.”

Una serie de datos de orden medico, sumamente importantes para esta-
blecer la etnologia medica de los aborigenes, se encuentran desparramados
en sus obras. Asi nos habla de la vida sexual, de las costumbres, de los
vestidos, del matrimonio. Luego de los sacrificios humanos, sobre los que
trae abundantes datos en el periodo pre-incaico. Despues, durante el Im-
perio, ellos se dedicaban al Sol 6 a los Reyes Incas. Cuando morian estos,
los embalsamaban; los procedimientos de= embalsamiento y momificacion,
parecidos a los que empleaban en el antiguo Egipto para conservar los
cadaveres de los personajes importantes. De alii la admiracion del Cro-
nista, cuando con Polo de Ondegardo, visita en el Cuzco la tumba del Inca
Viracocha a cuyo cadaver, bien conservado, no faltaba ni ceja, ni pestana.
La mejor descripcion de la sangria la hallamos en sus obras. Este pro-
cedimiento era ya utilizado para purificar los humores; y para aliviar los
dolores locales, 6 bien para ofrecer el precioso licor a los dioses de su
gentilidad, aunque esto ultimo acaecia principalmente en Mejico. No
faltaba en aquel regimen patriarcal, el cuidado de los ninos, para prevenir
su mortalidad, como tambien, la organizacion sanitaria admirable de los
mitimaes, que representa, para el profesor C. Monge, una indudable po-
litica sanitaria, para defender al hombre de los rigores del clima y para
favorecer, bien que empiricamente, el desarrollo demografico, base de todo
progreso social. De la higiene podemos sacar buenos atisbos en el culto
universal del bano, en la manera de lactar al nino, previniendo sus futures
trastornos dispepticos; en el momento mismo del parto, en la regulacion
de la alimentacion; en la purificacion de las enfermedades por los ayunos,
penitencias y la misma Citua o fiesta colectiva. Su obra nos trae datos
sobre el abuso que hacian de las bebidas, a la cabeza de ellas, la imperial
chicha, sobre idolatria, costumbres, folklore, siendo solo superada por las
magnificas de Molina, Morua, a Arriaga. Nos dice como creian en la
inmortalidad del alma, en la existencia del Anan Pacha o cielo alto, adonde
iban los buenos y el Veu Pacha 6 mundo bajo donde iban a para los malos.
Los secretos de las plantas indigenas, le han sido revelados por sus
parientes. AHi describe el arbol del maguey, la coca, las variadas resinas;
asi como el arte rudimentario de los Camasccas, practicos de la medicina
de entonces.

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143

Guaman Poma, el cronista indio ultimamente descubierto, nos trae una
serie de dates de inapreciable valor etnologico, que yo he puntualizado
otra vez. En su “ Cronica,” desperdigados aqui y alia, entre un monton
de descripciones poUticas, hay mucho de la medicina autoctona, aun cuando
el prolijo autor, nos dice de antemano que no es su objeto escribir sobre
ella: “ esto de las medicinas no lo escribo porque no puedo mas. . .
Pero quiera que no, tiene que tocarla y las veces que lo hace es para darnos
una idea de los barberos y cirujanos ya en la Colonia, de los hechiceros,
de las idolatrias, etc. etc. En ellas estan consignados los representantes
del arte de curar, los pontifices y hechiceros, con su indumentaria carac-
teristica; la vida sexual con sus desenfrenos, el trabajo en las minas con
su higiene precaria, el cultivo de la coca, el empleo de ciertas plantas, los
ayunos y penitencias; las procesiones, la fiesta de la Citua, la muerte y el
embalsamiento, las purgas y sangrias, asi como el masaje, la succion, la
psicoterapia, etc. etc.; y mucho de lo dicho, objetivado en preciosas
laminas, las que representan, hablando metaforicamente, una continuacion
de la labor ceramica de los antiguos alfareros. Laminas que han sido
correctamente ejecutadas a pluma y que “ muestran un talento que no es
mediocre.” El dibujante conoce poco de anatomia, pero es “ excelente en
al dominio de la expresion de la fisonomia y del movimiento,” en una
palabra de la psicologia. Objetiviza en sendos dibujos a pluma, cuanto
va describiendo, y en veces, tiene que medir las lineas del texto, para asi
no escatimar espacio al dibujo.

Guaman Poma es un indigenista cien por cien, por mas que lleve por
segundo apellido el de Ayala, o sea de aquel espanol a quien su padre
salvo en la batalla de Huarina. Y tiene orgullo de llevar en sus venas la
sangre de los Incas. Esta penetrado del mismo indigenismo romantico de
Garcilaso. De alH que su Cronica, sea una animada y constante ex-
teriorizacion de los vicios y desenfrenos de la dictadura espanola, comen-
tarios que muchas veces se tornan en diatriba despiadada. Los hechos por
el narrados, resultan asi cuadros pintorescos y animados de la vida colonial.
Bajo cierto aspecto de la medicina aborigen, supera a Garcilaso, Moriia,
Arriaga y otros. iQue capitulo mas interesante desde el punto de vista
etnologico, que aquel que trata de las distintas clases de hechiceros y
hechicerias! Y aquel otro de las abuciones, ayunos y penitencias en aquel
pueblo idolatra! . . .

La figura de Guaman Poma nos es hoy familiar y simpatica. Y yo in-
sisto aqui sobre ella, pues es un indigenista autentico, cuya vida triste y
miserable, es una epopeya digna de ser cantada, como el lo hizo con gal-
lardia en defensa de su sangre y de su raza. Felizmente para el, era

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JUAN B. LASTRES

humorista y su obra esta llena de formidables sarcasmos, como dice
Markham. Mezcla el espahol, con palabras quechuas y aymaras. Este
erudito, gusta de amontonar palabras, sin establecer periodos. Pero, j que
le vamos a pedir a este anciano melancolico, atosigado por el bilingiiismo?
Su manera de expresarse es arcaica; no quiere deleitar, sino enternecer,
para asi mover a los poderosos a la piedad y disminuir la opresion de su
pueblo. Pero esta misma primitividad y rudeza en el lenguaje, le hace
sincere y veridico. Su ideal dice Pietschmann, es la reorganizacion
modelada de los metodos administrativos del Imperio de los Incas. Quiza
si trabajo como interprete, cerca de los Corregidores a los cuales, luego
anatematiza. Y despues de haber cumplido esta epica Jornada, cargado
de anos y de desenganos, retoma al hogar. Este anciano melancolico y
triste, sintio palpitar en came propia, la melancolia y tristeza de toda su
raza vencida; y por eso es que su obra esta impregnada de profunda
tristeza e ironia. Al volver a su tierra, San Cristobal de Sondondo, todo
ha cambiado durante su larga ausencia. Es tratado como un impostor.
Asi este apostol del indigenismo, tiene que regresar miserablemente a
Lima, para ofrecer su linico tesoro, aquel que le consumio treinta anos
de su vida, su libro inmortal, nada menos que al Rey de Espaha. No se
engahaba respecto al destino inmediato de la obra de sus desvelos, in-
comprendida para su epoca. “ A algunos arrancara lagrimas; a otros
hara prorrumpir en maldiciones, a otros dara risa; estos lo encomen-
daran a Dios; aquellos de despecho querran destrozarlo; unos pocos
querran tenerlo en sus manos.” Hoy, despues de tres siglos, la queremos
tener constantemente en las manos, para admirar una vez mas, el ingenio
peregrino de su autor, al par que su sinceridad y hombria, al atreverse a
juzgar temerariamente, los sucesos de su epoca, desafiando gallardamente
las llamas de la Inquisicion 6 la colera de los poderosos de su tiempo.

En la principal obra del Padre Joseph de Acosta, “ Historia Natural y
Moral de las Indias,” obra que me propongo analizar posteriormente, hay
tambien datos aunque de importancia menor, que los encontrados en los
cronistas citados. Es con Cieza, quien primero nos trae descripciones
sobre el soroche al subir el mismo la sierra altisima del Pariacaca, en la
que siente “ aire sutil y penetrativo ” y aquella extrana destemplanza, con
todos los sintomas consiguientes. Nos habla tambien de las minas de
azogue, de las termas, del maguey, tunal, grana, anil, la piedra bezar, etc.
A la ligera toca el tema de las supersticiones y sacrificios “ sacrificaban a
los dioses muchas cosas, especialmente ninos y de su sangre hacian una
raya de oreja a oreja, en el rostro del difunto.”

MEDICINA ABORIGEN PERUANA

145

Faltan muchas otras obras por examinar. Las de Cobo, Molina, Morua,
Arriaga y muchos otros documentos que vienen publicando las Revistas
Historicas y del archive Nacional y que se exhuman, y comentan gracias
al entusiasmo que han despertado estos estudios con la creacion de la
Sociedad Peruana de Historia de la Medicina. Del cortejo final de todas
estas fuentes, vendra la luz en esta complicada marana de la medicina
aborigen.

Uno de los temas modernos, sobre el cual mas han investigado los
medicos y antropologos, es en el inmenso campo de la paleo-patologia. Y
es en verdad, donde se pueden conseg^ir datos de gran objetividad.

Aparte las enfermedades descritas antiguamente y de cuya existencia
sabiamos por el folklore o el vocabulario, como el paludismo, la verruga,
el reumatismo, etc., tenemos otras descubribles por el estudio macroscopico
y microscopico de los huesos. Esta investigacion esta en sus comienzos.
De antiguo, el hueso constituye una fuente importante de estudio, prin-
cipalmente para determinar las enfermedades cronicas, como la tubercu¬
losis o la sifilis, que han dejado huella indeleble en su estructura. Pero
tambien sirve, para establecer caracteristicas antropologicas de los es-
queletos dejados por los antiguos peruanos. Aun cuando antes de hacer
la investigacion, hay que precaverse del error, respecto a la edad y proce-
dencia, porque es frecuente encontrar en los museos nacionales, piezas
oseas de edad reciente.

En este sentido antropologico y paleo-patologico, hay numerosas con-
tribuciones. La de Ales Hrdlicka, sobre el femur en los viejos peruanos,
estudio llevado a cabo sobre 5.300 huesos, en que se encontro al analisis
de la estructura del femur, notable por su homogeneidad, diferenciandose
en cortos detalles, de aquel del indigena de la America del Norte. Ultima-
mente, los estudios de Sergio Quevedo, sobre los antiguos pobladores del
Cuzco, en la region de Calca y sus mediciones antropometricas de craneos
y huesos largos. Ademas otras caracteristicas de la antigua raza, que ya
ha sido especificada por Morales Macedo, Palma y otros, sobre la
existencia de la fosita aymara, el hueso epactal, etc.

Forma practica y cientifica, la que utiliza Roy L. Moodie (Surgery in
Pre-Columbian Peru ^ y Roengenologic Studies of Egyptian and Peruvian
Mummies), en sus estudios de paleo-patologia sobre Momias peruanas.
Por primera vez aplica los rayos X y encuentra datos de interes, como
swi la rareza de la arterioesclerosis, las lesiones potticas de la columna

* Annals of Medical History, 1929, N. S., Vol. I, pp. 698-728.

146

JUAN B. LASTRES

vertebral, las curiosas otoesclerosis, las deformaciones de los huesos del
craneo, la osteomalacia y las porosidades en los huesos del craneo, etc.
Hrdlicka ha encontrado igualmente artritis, osteomielitis, y otras lesiones
articulares.

La cirugia precolombiana, no estaba tan desarrollada, como afirman
ingenuamente algunos. Casi toda ella se reducia a las trepanaciones, y
muchas de estas eran hechas para curar fracturas del craneo, como afirma
Moodie. Por esto le llama “ procedimiento militar.” Mucho se ha escrito
sobre ellas; y sin embargo, todavia no se llega a conocer bien los motivos
de esta operacion. Se llega hasta afirmar enfaticamente, que se la prac-
ticaba para curar la presion endocraneana. Burton sostiene que en un
especimen, se opero para extraer un tumor del cerebelo. Otros para curar
la melancolia 6 por motivos religiosos. El mismo Broca, en un craneo
que le fue enviado de Yucay, creyo que se trataba de un derrame sanguineo
o hematoma y que el cirujano indio, trepano para evacuar el hematoma.

Creemos que la trepanacion fue empirica las mas de las veces, pues eran
escasisimos los conocimientos que tenian los Camasccas sobre el encefalo.
La misma epilepsia, que unos han invocado ser la causa de muchas tre¬
panaciones, queda desechada, por creerse en el folklore, que la causa de
ella, radicaba en el corazon. Es mas logico suponer con Lavoreria, que en
los casos de orden medico, fue “ sortilega o taumaturgica ” sin un conoci-
miento cabal de las enfermedades intra-craneanas. Hasta acaso podria
haberse verificado, conforme afirma Posnansky, a manera de sacrificio,
confirmando lo aseverado por el folklore. Asi, en el Altiplano sudameri-
cano, existe una tradicion, que da cuenta “ como los sacerdotes, durante
ciertas fiestas, absorvian los sesos de los sacrificados.” Creemos que la
trepanacidn de orden medico, no ha sido motivada por procesos definidos
de indole nerviosa, (paralisis, epilepsia, compresidn del encefalo, etc.;
salvo la cefalea, uma nanay) sino mas bien, de orden quirurgico, externo,
por fracturas principalmente.

Colaboracion de primera linea para el estudio de las trepanaciones,
prestan los rayos X. Los comenzamos a emplear con Gonzalez Vera hace
algpinos anos. Los craneos observados pertenecian al Museo Nacional de
Arqueologia. Veamos algunos de los informes sobre craneos trepanados.

Craneo No. 453. “ La radiografia de perfil muestra una pequena imagen
de perdida de sustancia osea, bien limitada, que se proyecta en la parte
superior y media del frontal, rodeada de una faja de mayor densidad,
debida a esclerosis: cicatricial ?.”

Craneo No. 362. “ La radiografia en perfil, sobre el lado izquierdo del
craneo muestra a la porcion supra-orbitaria del frontal, bastante dirigida

MEDICINA ABORIGEN PERUANA

147

hacia atras y casi rectil'mea, presentando en dicho hueso, una pequena
zona, bien limitada, de aumento de transparencia por perdida de tejido
oseo, visible inmediatamente por debajo de la tabla interna, a poca dis-
tancia por encima del techo de la orbita.”

Crdneo No. 5707. “ La radiografia en perfil sobre el lado derecho del
craneo, muestra una deformacion de la calota por aplanamiento e in-
clinacion hacia atras y aba jo del frontal y parte anterior de los parietales.
La parte media de estos, forma una curva bastante cerrada, para descender
casi verticalmente, continuandose con el occipital, hasta el nivel de la
protuberancia occipital externa. Existe ademas, dos amplias zonas de
aumento de transparencia por ausencia de las porciones oseas corre-
spondientes; la anterior algo mayor, de forma mas trapezoidal, se extiende
desde nivel del piso medio hacia arriba y atras, superponiendose por su
porcion postero-superior a la porcion antero-superior de la zona posterior,
cuya forma se asemeja algo a la primera, interesando a la parte postero-
inferior del parietal derecho y supero-inferior del occipital. Los hordes de
dichas zonas son bastante precisos y algo irregulares. La estructura y
opacidad osea circundante, no estan modificadas.” El mismo Dr. Gonzalez
Vera, ahade que “ Tratandose de craneos aislados del resto del esqueleto,
nos habria sido facil obtener mejor visualizacion de las lesiones, pero,
{Kira dar ideas al mismo tiempo del grado de las deformaciones globales,
hemos preferido recurrir a las posiciones usuales. En algunos casos hemos
cumplido con ambas finalidades.”

CcMno se ve, hay datos de interes en la radiologia de estos craneos y
(jue se necesita hacer estudios mas numerosos, para asi determinar el por-
centaje de supervivencia del herido. Estos estudios iniciados por Leon
Pales y Guiard (1930), son muy utiles. Guiard sostiene que cuando los
craneos trepanados, presentan el horde de la trepanacion ligeramente es-
fumado, pertenecen a individuos muertos algunas semanas despues de la
operacion. Cuando la zona circundante es mas densa (anillo oscuro) de
tejido compacto pertenecen a sujetos que han sobrevivido muchos meses.
Y cuando los craneos que tienen anillo oscuro, alejado del orificio trepa-
nado, traducen una supervivencia de anos.®

*Roy L. Moodie (Roentgenologic studies of Egyptian and Peruvian Mummies, Chicago,
U. S. A., 1931), es quien ha hecho estudios muy novedosos en materia de paleo-patologia,
aplicando los rayos X, a las momias peruanas. Casi todos los ejemplares, pertenecen al
Field Museum de Chicago y han sido utilizados por Moodie, para esta clase de investi-
gaciones. Es asi como encuentra un craneo hidrocefalo en un niho; la piorrea alveolar;
la absorcion alveolar motivada por la piorrea. Muchos craneos trapanados en que la
radiologia demuestra que la c^racion fue fatal, y hace decir a Moodie que fue una
medida militar. Un caso de tumor de la rama ascendente del maxilar; fistulas que se

148

JUAN B. LASTRES

Los estudios macroscopico y microscopico de las momias, ban dado
buenos resultados en manos del tnalogrado Williams. Se colocan los
tejidos en soluciones apropiadas, 1% de formaldehida, despues tratarlos
por alcohol y luego imbibirlos con colodion y parafina. Es asi como ha
examinado dos momias peruanas: miisculos, tendones, arterias y nervios,
identibcables facilmente por la diseccion. En cambio, el conectivo y el
tejido adiposo, fueron reconocidos con dibcultad. Se hicieron cortes de la
arteria tibial posterior, en la que fue facilmente reconocible la ultima calci-
ficada y un trombo igualmente calcificado. En una de las momias se pudo
observar una marcada osteo-artritis espinal.

Tambien se ban hecho estudios sobre los grupos sanguineos en las
momias, encontrandose que predomina el grupo A, para el Peru. El Dr.
Pedro Weiss, ha encontrado piojos en las momias de Paracas.

Se ha hablado tambien del trasplante de huesos, aunque esto no es
creible para Moodie. Las amputaciones que se practicaban, no han dejado
rastros en los huesos, pero si en la ceramica. En un Album recientemente
confeccionado por nosotros, encontramos muchos huacos con esta par-
ticularidad: amputacion sobre todo del pie izquierdo (mutilacion puni-
tiva?) en el tercio inferior de la pierna.

La obesidad la he estudiado en otra ocasion. Me han servido diversos
huacos: dos con esteatopigia, perturbacion en la distribucion periferica de
la grasa, que obedece seguramente a un factor hipofisario. Otros speci¬
mens, con obesidad generalizada, con perturbacion seguramente de varias
glandulas: hipohsis, tiroides y aiin cortical. El mixedema y la obesidad
hipo-tiroidea, la hemos hallado en una lamina de Guaman Poma y en
alg^nos huacos muchiks y nasquenses. Ya Morua dice: “Que eran los
indios de mediana estatura y un poco morenos, traian el cabello corto y
los demas indios lo traian en general largo y la barba rapada.” Y el Padre
Cobo, ahade: “. . . son todos naturalmente flematicos de complexion,
y como la flema natural hace blanda y humeda la sustancia de los miembros
del cuerpo y asi se cansan presto y no son para tanto trabajo como los de
Europa. Junto con ser flematicos, son en extremo sanguineos, de donde

abren en el seno maxilar, indicando infecciones dentarias. Artritis deformantes, en que
las superficies articulates estan corroidas, lo que hace sospechar la causa tuberculosa.
Artritis deformantes de las antiguas pelvis. Tumor epicranial e hiperostosis del craneo.
La osteoporosis por defectos en la nutricion en ninos. Lesiones en el meato auditive
izquierdo; la otitis media; los abscesos del oido, etc. La arterioesclerosis seria rara en
concepto de Moodie y frecuente en cambio, entre los antiguos egipcios. La piorrea
alveolar seria para el la responsable de gran numero de cambios en los dientes. La radio-
grafia de un tumor calcificado de la dura madre (Plate XXXIII) es muy ilustrativa.

Todos estos datos evidenciados por Moodie, fijan objetivamente la patologia del incario.

MEDICINA ABORIGEN PERUANA

149

les hace ser excesivamente calidos. ...” Gutierrez Noriega, que ha hecho
recientemente algunos estudios sobre la constitucion en la raza India, in-
dica que en ella prevalecen los tipos picnico leptosomico en los indios de la
costa y leptosomo-picnico en los Andes. Las esquizofrenias y melancolias,
han sido mas frecuentes en el andino y las manias en el costeno. For
ultimo, en relacion con el temperamento: el esquizotimico predomina
entre los andinos y el ciclotimico, entre los costenos.

Ultimamente, Gonzalo Eyzaguirre, ha evidenciado en gran numero de
ceramios, la frecuencia del pie piano; y que esta frecuencia es mayor entre
los indios de raza pura, que entre los yungas y muchiks; y entre los pic-
nicos, que entre los leptosomos.

Dos enfermedades intrigan constantemente a los clinicos: la sifilis y
la tuberculosis. El problema de la sifilis, ha sido revisado con criterio
mas t^nico por Herbert Williams y J. Tello, los que en una serie de
huesos largos y en un craneo procedente de Paracas, hacen estudios histo-
logicos y de rayos X. En esta ultima investigacion, descubren engrosa-
miento del periostio y exclaustramiento del canal medular en los huesos
largos. Son imagenes superponibles a las producidas por las periostitis y
osteomielitis que produce la sifilis. En cuanto a los estudios histologicos,
la estructura coincide con aquella de los huesos largos sifiliticos, dada por
Weber y Nestmann. El mismo Williams describio en 1932, varios huesos
precolombianos con lesiones analogas a las producidas por la sifilis. Estos
estudios, si bien son mas convincentes, que los anteriormente hechos,
tienen necesidad de ser seguidos de otros, que lleven al espiritu una mayor
claridad a este delicado problema.

Respecto a la tuberculosis, Garcia Frias ha encontrado en momias
peruanas, lesiones de espondilitis tuberculosa. En los pulmones, lesiones
tipicas, foco de Gohn calcificado, complejo primario, etc. Yo he con-
tribuido en este sentido, presentando ocho ceramios con la deformacion
caracteristica.

La literatura barata que ha engendrado el conocimiento superficial de
la civilizacion incaica y el estado de la medicina de entonces, hace decir
una serie de despropositos, que a traves del tiempo y sin un analisis
critico, se vienen repitiendo constantemente. Es asi como entre otras
muchas cosas, leemos lo siguiente: ” En las grandes ciudades existian
verdaderos hospitales.” Luego: ” Los m^icos de los Incas gozaban de
una profesion predilecta que siempre estaba de acuerdo con sus facultades,
los curanderos del pueblo segun la clase de clientela que tenian, pertenecian
a la categoria inferior de Sacerdotes o la de los trabajadores manuales.

150

JUAN B. LASTRES

Existian los cirujanos (Sircak), los magos sacerdotes, los herboristas,”
etc. Y para redondear esta falsedad, dice el autor “ Existia una clasi-
bcacion casi completa en las diferentes labores que debian realizar la clase
medica, indicando como abarcaban todos los diferentes aspectos de la
medicina. . . Es decir en buena cuenta, que sucedia como en el me¬
mento actual, con todas las especialidades y especialistas que contamos,
teniendo desde luego en primer termino, al neuro-cirujano, especialidad,
que ahora recien comienza por el mundo. No falta a esta larga relacion
de medicos y enfermedades, los “ habiles cirujanos que practicaban la
trepanacion craneana. Y a proposito de las trepanaciones, debemos con-
signar el hecho muy sugestivo, sobre el cual debe fijarse atencion pre-
ferente, y es el silencio absolute de los cronistas sobre ellas, cuando no se
cansan de describir hasta el menor detalle, las yerbas, las idolatrias, etc.

Faltaria estudiar en este trabajo de sintesis de la medicina aborigen,
los trabajos y monografias hechas por medicos. Resalta entre ellos el de
Daniel E. Lavoreria (El arte de curar entre los antiguos peruanos),
trabajo muy bien confeccionado, a pesar de la epoca en que se hizo. Coloca
la medicina en su verdadero piano, pues las ciencias en ese entonces, estaba
en estado primitive, “ porque estando fundadas estan en la observacion
y la experiencia y careciendo los indios de escritura u otro medio de con-
servar y transmitir las ideas adquiridas, era imposible el progreso, desde
que cada uno tenia que atenerse a su propria observacion, sin poder
utilizar los resultados de la experiencia de sus antecesores.” Y agrega que
en anatomia y fisiologia tuvieron conceptos elementales, pues no existen
voces en su idioma, para desig^ar organos y visceras. Este date, aiin
cuando esta contradicho por Olano, es natural que asi fuera, porque eran
supersticiosos y temerosos de la divinidad, y no se atrevian a abrir el
vientre. En cambio, en botanica, les concede mayores conocimientos,
principalmente en los que atane a las yerbas y plantas medicinales. Se
atenian “ a lo sobrenatural ” en el tratamiento de las enfermedades, etc.

Todavia nos falta estudiar las otras monografias y el espiritu de sus
autores. Pero debemos decir ahora, y poniendonos en un terreno eclectico,
que la medicina aborigen peruana, pertenece al rango de las medicinas
primitivas. “ Los escritores modernos, dice Moodie, fascinados por las
antiguas culturas, les ban atribuido pensamientos e interpretaciones, hasta
practicas cientificas que rebasan los limites de sus posibilidades.” Y esto
es cierto. Es verdad que tuvieron algunas rudimentarias ideas sobre
higiene y contagio y algo de pericia en la cirugia y que si practicaron la
trepanacion, han debido practicar igualmente operaciones de cirugia
menor. No abrieron el abdomen de los enfermos y los procedimientos de

MEDICINA ABORIGEN PERUANA

151

embalsamiento, que todavia no se conocen en detalle ni la sustancia que
empleaban, fueron inferiores a los que empleaban los egipcios.

Terminare diciendo que la medicina aborigen peruana esta por hacerse.
Falta mucho por analizar. Luego de haber escanciado todas las fuentes
historicas y los procedimientos auxiliares que hoy se usan, como aquellos
de los rayos X, de los cortes, grupos sanguineos, etc. se puede hablar con
algiin fundamento de paleo-patologia.

Si ha analizado ahora a cada cronista en especial, como Garcilaso y
Guaman Poma, es para estudiar el dinamismo en sus Cronicas y puntualizar
asi la ideologia de cada autor, frente al eterno problema de la cultura.

Un punto importante sobre el cual vuelvo a insistir. La medicina
aborigen peruana, es igual a las otras medicinas aborigenes de America,
es decir de la medicina primitiva. Analoga en especial a la mejicana,
porque el adelanto de la civilizacion, corrio paralelo en ambos paises. Ya
se ha comenzado felizmente a separar lo garrulo y superficial que se habia
tejido sobre ella; para llegar a la fase de critica y de verdadera ciencia.
Solo asi, cuando hallamos terminado esta etapa, podremos hablar con
fundamento de la medicina aborigen peruana.

A SHORT CHRONOLOGY OF IMPORTANT EVENTS IN
CARDIOLOGY

ALDO A. LUISADA

History of Medicine has been considered in the past as a unitary
science. The progress of Medicine in general and the inevitable trend
toward specialization, however, has given rise in recent years to books
which consider only a limited branch of Medicine, such as Cardiology (3).

Chronological listing of important events is undoubtedly a sketchy and
incomplete way of describing them. Still it has a certain importance, as it
enables students of the subject to grasp at a glance the conditions of a
part of Medicine in any particular year, and also makes it possible to
remember trends of thought and tendencies of this or that period. This
has been well illustrated by chronological listings in recently published
books, like Cardiac Classics (7) and the well-known Textbook of Heart
Disease by P. D. White (6).

If one wishes to enumerate the important events in Cardiology, he must
follow some rules which will give to the list a more definite value:

(1) All those branches of Medicine which have had any essential
influence on the study of Cardiology will be considered even though the
students of that particular branch might have had other problems in
mind, or are known mainly for other works. As an example, Roentgen’s
work holds for the cardiologist an importance which may be compared to
that of Einthoven’s, even though the discoverer of the x-ray was not
looking to the possibility of its application in Cardiology as was the
inventor of the string galvanometer.

(2) Further, all those studies having had any influence on the develop¬
ment of Cardiology will be considered, without regard for language,
race, or nationality. In other words, since all important works made by
men in any country have sooner or later repercussions and effects on the
studies subsequently made by men in other countries, a listing of impor¬
tant discoveries and studies should surmount any barriers of language
and of political borders. The necessity of this is proven by the fact that
many students born in one country and later working in another, have
either come back to their mother country, or settled in the new land, or
even gone to a third as teachers.

(3) The names of the students shall be given in their original form

152

A SHORT CHRONOLOGY OF IMPORTANT EVENTS IN CARDIOLOGY 153

without any change or translation. They will be followed by the nation¬
ality, and by the name of the country in which they worked. The historical
development of some nations makes it advisable to name certain nationali¬
ties, such as the Irish, the Finnish, or the Bohemian, even though at the
time in which that student was working, Ireland was part of the British,
Finland a part of the Russian, and Bohemia a part of the Austrian
Empire.

(4) As the judgment of what is really important for the development
of Cardiology is essentially subjective, we have included for the sake of
objectivity:

(a) those students who gave their name either to a clinical sign or to

a syndrome;

(b) those who made possible a definite advancement of Cardiology;

nized as of paramount importance at the time of its publication;

(d) those students whose work made possible a better understanding

of the functions and dysfunctions of the heart;

(e) those who devised some new instrument or a surgical interven¬

tion which is still recognized as important in Cardiology.

(5) As a rule, historical studies should include only the students of
the past, since their work can be considered with a certain time perspec¬
tive. However, since Cardiology has made tremendous advances in the
last twenty years, some of the students to whom we owe much are still
alive. This makes it imperative that their names be mentioned, even
though future workers will be able to evaluate their work better than
those of the present.

(6) The fields of study on which modern Cardiology is based are the
following: Anatomy, Physiology, Pathology. Pharmacology, Physics,
General Medicine, Surgery, Roentgenology, Physical Diagnosis, and
Comparative Biology.

(7) It is sometimes difficult to date the main work of a particular
student, since his work might have extended through many decades, and
his publications and his discoveries been of large number. We have
resorted to the following device: when the fundamental study was included
in a textbook, or in a Monograph, we have recorded the date of the book,
followed by a short description of the main contributions, even though
they were made before or after that date; when a student had his name
connected to two or three different and important contributions, his name

154

ALDO A. LUISADA

has been repeated at a different date, so that the importance of the many

contributions be not diminished.

The following chronological list starts from 1500, namely from the

beginning of modern times.

1530—Leonardo Botallo—(Italian working in France)—Description of the ductus
arteriosus and of the foramen ovale.

1543—Andreas Vesalius—(Belgian working in Italy)—Anatomical description of
the human heart; clinical diagnosis of the aneurysms.

1559—Andrea Cesalpino—(Italian)—Introduction of the expression **blood
circulation.”

1628—William Harvey—(Englishman working in Italy)—Demonstration of the
blood circulation without any interruption.

1661—Marcello Malpighi—(Italian)—Proof of the capillary circulation; descrip¬
tion of the capillaries.

1708—Antonj van Leeuwenhoek—(Dutchman)—Conception of the pulse.

1715—Raymond Vieussens—(Frenchman)—Description of the coronary circula¬
tion ; description of mitral stenosis.

1749—Jean Baptiste de Senac—(Frenchman)—Textbook on Heart Diseases; qui¬
nine treatment of the heart palpitation.

1761—Giovanni Battista Morgagni—(Italian)—Studies on the pathology of many
lesions of the heart and of the vessels, including the calcification of the
coronary arteries. Description of the syndrome of “ pulsus rarus perma-
nens” (later called Stokes-Adams’ syndrome).

1761—Leopold Auenbrugger—(Austria)—Studies on the percussion of the heart
dullness.

1768—William Heberden—(Englishman)—Clinical description of angpna pectoris.

1785—William Withering—(Englishman)—Introduction of digitalis in the treat¬
ment of congestive failure.

1806—^Jean Nicolas Corvisart—(Frenchman)—Description of the clinical signs
caused by the stenosis of the different valves; important Textbook of
Cardiology.

1815—^Joseph Hodgson—(Englishman)—Textbook on the Diseases of the Arteries
and Veins; studies on syphilitic aortitis and on syphilitic aortic insuflS-
ciency (Hodgson’s disease).

1818— John Cheyne—(Irishman)—Description of the periodical respiration:

Cheyne-Stokes’ respiration.

1819— Rene T. H. Laennec—(Frenchman)—Textbook on Auscultation; invention

of the stethoscope.

1822—Richard Bright—(Englishman)—Studies on nephritis and on repercussions
of this disease on the heart.

1832—Dominic John Corrigan—(Irishman)—Description of the clinical picture
of aortic regurgitation; the Corrigan’s pulse.

1839— Joseph Skoda—(Austrian)—Textbook on Percussion and Auscultation.

1840— Jean Baptiste Bouillaud—(Frenchman)—Book on rheumatic fever; impor¬

tance of this as a cause of heart disease. The rheiunatic fever is called
Bouillaud’s disease.

A SHORT CHRONOLOGY OF IMPORTANT EVENTS IN CARDIOLOGY 155

|g46__CarI F. Ludwig—(German)—Perfusion of the isolated mammal’s heart.
1854—Armand Trousseau—(Frenchman)—The paracenthesis of the pericardium.
1854—William Stokes—(Irishman)—Textbook of Cardiology—The periodical
Cheyne-Stokes respiration; the Adams-Stokes syndrome.

1861—Paul Louis Duroziez—(Frenchman)—Description of the double murmur
on the femoral artery in aortic insufficiency; studies on the hemodynamics
of this disease. Studies on pure mitral stenosis: Duroziez’s disease.

1861— Auguste Chauveau—(Frenchman)—Studies on the intracardiac pressure of

the horse.

1862— Maurice Raynaud—(Frenchman)—Studies on the vaso-spastic syndrome

oi the extremities: the Raynaud’s syndrome.

1862—Austin Flint—(U. S. A.)—Description of the functional diastolic apical
murmur in aortic insufficiency: the Austin Flint murmur.

1867—Pierre C. E. Potain—(Frenchman)—Description and study of the pulsations

of the jugular veins.

1867— Thomas Lauder Bnmton—(Englishman)—Introduction of amyl nitrite in

the treatment of angina pectoris.

1868— Heinrich Quincke—(German)—Study on the capillary pulse in aortic insuf¬

ficiency: the Quincke’s pulse.

1871— Ilia de Cyon—(Pole working in France and Russia)—Description of the

depressor nerve; Cyon’s nerve.

1872— Rudolph Virchow—(German)—Studies on aortic hypoplasia.

1872—Ludwig Traube—(German)—Description of pulsus altemans. Study on
the double tone of the femoral artery in aortic insufficiency: the double
tone of Traube.

1872- 1877—Luigi Luciani—(Italian working in Italy and Germany)—Study on

the esophagocardiogram and on the pulse waves of the respiratory curve.
Studies on the periodic activity of the frog^s heart: the periods of Luciani.

1873— Adolf Kussmaul—(German)—Periarteritis nodosa. The paradoxical pulse

in adhesive pericarditis: Kussmaul’s pulse.

1875—Ercole G. Galvagni—(Italian)—The oral auscultation. Studies on adhesive
pericarditis.

1875— Carl v. Rokitansky—(German)—Studies on the septal defects of the heart

and on many other congenital anomalies. Classic book of Pathology of
the Heart and Vessels.

1876— Julius Cohnheim—(German)—The paradoxical embolism. The pulmonary

edema. Experimental studies on many cardio-vascular diseases. Studies
on amyloid degeneration of the myocardium.

1877— Aristide Stefani—(Italian)—Studies on active diastole of the heart and

on the function of the arteries. The pericardial fistula.

1878— William S. Oliver—(Englishman) ) — ( Studies on the tracheal signs of
—Antonio Cardarelli—(Italian) j — (aortic aneurysms: the signs of

Oliver-Cardarelli.

1879— Henri Roger—(Frenchman)—Study of the clinical syndrome due to inter¬

ventricular septum defect: Roger’s disease.

1879—Leonard Landois—(German)—Physiology of the heart: Textbook of
Physiology.

156

ALDO A. LUISADA

1881—Sigmund v. Basch—(German)—Description of the sphygmomanometer.

1883—Otto Schmiedeberg—(German)—Experimental studies on digitalis.

1885—fitienne J. Marey—(Frenchman)—Textbook on the Graphic Method in
Experimental Sciences and in Clinical Studies: the Marey tambour.

1885—Pierre C. E. Potain—(Frenchman)—Studies on the gallop rhythms; the
“ opening snap ” of mitral stenosis.

1885—William Osier—(Canadian working in Canada, U. S. A. and England)—
Studies on bacterial endocarditis: the Osier nodes.

1888—Etienne L. A. Fallot—(Frenchman)—Description and studies on the “blue
babies ”: the trilogy and the tetralogy of Fallot.

1888— Graham Steell—(Englishman)—Description of the diastolic pulmonary

murmur in mitral stenosis: the Graham Steell murmur.

1889— Leon Bouveret—(Frenchman)—Description of paroxysmal tachycardia:

Bouveret disease.

1891—Friedrich Trendelenburg—(German)—Studies on varicose veins: the
operation of Trendelenburg.

1891—Scipione Riva-Rocci—(Italian)—Description of the mercury type of sphyg¬
momanometer: the apparatus of Riva-Rocci.

1893—Wilhelm His, Jr.—(German)—Demonstration of the auriculo-ventricular
bundle: the His bundle.

1896—Wilhelm K. Roentgen—(German)—Description of the X-ray.

1896— Friedel Pick—(German)—Studies on adhesive pericarditis with liver cir-

rosis: the Pick syndrome.

1897— Victor Eisenmenger—(German)—Studies on congenital heart diseases:

the Eisenmenger complex.

1897—William H. Broadbent—(Englishman)—Studies on pericarditis.

1899— Henri Huchard—(Frenchman)—Textbook of Cardiology. Studies on

hypertension and on aortitis: the hypertensive Huchard’s syndrome.

1900— Guido Pagano—(Italian)— ) „ „

-Luigi Siciliano-(Italian)-^ Studies on carotid sinus reflexes.

1901— Abel Ayerza—(Argentinian)—Clinical description of the “ black cardi¬

acs ”: the syndrome of Arrillaga and Ayerza.

1901— Luis Morquio—(Urug;uayan)—Description of the congenital heart block:

the Morquio syndrome.

1902— James Mackenzie—(Englishman)—Monograph on the pulse.

1903— Willem Einthoven—(Dutchman)—Description of the string galvanometer.

Different studies of electrocardiography. The first phonocardiograras.

1903— Karel F. Wenckebach—(Dutchman working in Germany and Austria)—

Studies on cardiac arrhythmias: the Wenckebach periods. Quinidine in
the treatment of heart disease.

1904— Ludwig Aschoff—(German)—Studies on myocarditis: the Aschoff nodules.

Studies on the structure of the normal heart: the Aschoff-Tawara node.

1905— Nikolai S. Korotkov—(Russian)—The auscultatory method and the clini¬

cal measurement of the diastolic pressure.

1905—^Jakob Pal—(Austrian)—Studies on vascular crisis.

1905— Pietro Grocco—(Italian)—Studies on aortic aneurysms. Studies on per¬

cussion of the heart.

1906— August V. Wassermann—(German)—The Wassermann test.

A SHORT CHRONOLOGY OF IMPORTANT EVENTS IN CARDIOLOGY 157

1906— Albert Fraenkel—(German)—The first intravenous injections of stro-

phanthin in congestive failure.

1907_Arthur Keith and Martin Flack—(Englishmen)—Description of the sino-
auricular node: the node of Keith and Flack.

1907— Guido Banti—(Italian)—Studies on the venous cirrhosis of the heart.

1907— Adolf Sahli—(German)—Studies on sphygmobolometry—Classic book of

Physical Diagnosis.

1908— James Mackenzie—(Englishman)—Studies on auricular fibrillation.

1908—Sunao Tawara—(Japanese working in Germany)—Studies on the struc¬
ture of the normal heart: the node of AschofF-Tawara.

1908—Maude Abbott—(Canadian)—Studies on congenital heart diseases.

1908— Leo Buerger—(U. S. A.)—The syndrome of thromboangiitis obliterans of

the young: Buerger syndrome.

1909— Friedrich Trendelenburg—(German)—The embolectomy in pulmonary

embolism: operation of Trendelenburg.

1909—Michel-Victor Pachon—(Frenchman)—The Pachon oscillometer; studies
on blood pressure.

1909—Carl J. Rothberger—(Austrian)—Studies on auricular fibrillation and on
premature beats. •

1909- 1910—Thomas Lewis—(Englishman)—The clinical diagnosis of auricular

fibrillation. Studies on arrhythmias. Monogfraph on Graphic Registra¬
tion of the Heart Beat

1910— Hans v. Recklinghausen—(German)—Studies on the pulse; studies on

blood pressure.

1910-1914—Maximilian Sternberg—(Austrian)—The “ pericarditis episteno-
cardica.” Studies on aneurysms of the heart.

1910—Hugo Schottmueller—(German)— ) « j- l • . j j- •
-Emanuel Libman-(U. S. A.)- \ S*"*^*^® hactenal endocarditis.

1910—Walter Straub—(German)—Studies on the isolated frog^'s heart: the Straub
heart.

1910—W. P. Obrastzow and N. D. Straschesko—(Russians)—Studies on coro¬
nary thrombosis.

1910—Henri Vaquez—(Frenchman)—The theory of partial failure of the heart:
left and right ventricular failure.

1912—Francisco C. Arrillaga—(Argentinian)—The arteritis of the pulmonary
artery and the arteriosclerosis of the pulmonary vessels: the syndrome of
Arrillaga and Ayerza.

1912—Ernest H. Starling—(Englishman)—Studies on the heart-lung prepara¬
tion on dog: the laws of the normal heart, or Starling^'s laws.

1912— James B. Herrick—(U. S. A.)—Description of the clinical picture of myo¬

cardial infarction.

1913— Henri Vaquez and Emile Bordet—(Frenchmen)—Roentg^ology as an

auxiliary branch of Cardiology: a well known Textbook.

1914— Richard C. Cabot—(U. S. A.)—Classification of heart diseases.

1914—Otto Frank—(German)—Technique of recording the heart sounds: the
Frank capsule.

1914—Franz Volhard—(German)—Studies on nephritis and hypertension.

158 ALDO A. LUISADA

1915—Hans Mautner and Ernst Peter Pick—(Austrians)—Studies on the venous
sluices of the liver and of the lungs.

1919—Adolf Spitzer—(Austrian)—Studies on the pathogenesis of congenital
heart diseases: the Spitzer theory.

1919— Augusto Murri—(Italian)—The laws of the damaged heart, or Murri’s
laws.

1920— Harold E. B. Pardee—(U. S. A.)—The coronary T wave of the electro¬

cardiogram : the Pardee T wave.

1920— Louis Gallavardin—(Frenchman)—Monograph on Blood Pressure. Multi¬

ple studies of Cardiology.

1921— Herbert Assmann—(German)—Classic textbook of Roentgenologfy.

1921—Rene Lutembacher—(Frenchman)—.Studies on arrhythmias of the heart.

Studies on congenital heart diseases: the Lutembacher syndrome.

1921—Thomaso Jonnesco—(Rumanian)—Surgical treatment of angina pectoris
by cutting the sympathetic pathways.

1921—Henri Vaquez—(Frenchman)—Qassic textbook of Heart Diseases. Multi¬
ple works on heart diseases.

1921—Otto Loewi—(Austrian)—Studies on the vagal substance of the frog’s
heart.

1921—Robert Tigerstedt—(Finn working in Germany)—Textbook on Physiology
of the Circulation. Multiple experimental studies on the heart and vessels.
1921-1926—Charles Laubry (Frenchman) and Cesare Pezzi (Italian working in
France)—Monograph on Congenital Heart Disease. Monograph on
Gallop Rhythms. Multiple studies of Cardiology.

1924—August Krogh—(Danish)—Studies on the capillaries. Monograph on this
subject.

1924—^Tiburcio Padilla—(Argentinian)—Monograph on Electrocardiography.

1924— Johann G. Moenckeberg—(German)—Textbook of Pathology of the Heart.

Studies on arteriosclerosis.

1925— Nikolai Anitschoff—(Russian)—Studies on arteriosclerosis; studies on

myocarditis.

1926— Herbert Elias and Adolf Feller—(Austrians)—Studies on congestive

failure.

1926— David Scherf—(Austrian)—Studies on the troubles of the auricular myo¬

cardium; multiple studies of Cardiology.

1927— Karel F. Wenckebach (Dutchman working in Germany and Austria) and

H. Winterberg—(Austrian)—Classic Textbook of Arrhythmias of the
Heart.

1927—Henri Fredericq—(Belgian)—Studies on the physiology of the myo¬
cardium.

1927—Ludolph Brauer—(German)—Studies on pericarditis; the Brauer’s opera¬
tion in adhesive pericarditis.

1927—Hans Hering—(German)—Studies on carotid sinus reflexes.

1927— Herrman L. Blumgart—(U. S. A.) and Soma Weiss (Hungarian working

in U. S. A.)—Studies on circulation time.

1928— Carl J. Wiggers—(U. S. A.)—Textbook of Physiolc^ of Circulation.

Studies on hemodynamics of valvular defects.

A SHORT CHRONOLOGY OF IMPORTANT EVENTS IN CARDIOLOGY 159

1930— Frank N. Wilson—(U. S. A.)—Studies on bundle—branch block and on

precordial leads.

1931— Ernst Edens—(German)—Textbook of Cardiology.

1931—Hermann Rein—(German)—Physiology of coronary circulation; descrip-

-Well

Studies and monographs
on coronary circulation and
on coronary heart disease.

tion of the “ Thermostromuhr.”

1931— Paul D. White—(U. S. A., working in U. S. A. and in England)-

known textbook of Cardiology. Multiple studies of Cardiology.

1932— Luigi Condorelli—(Italian working in

Austria and Italy)—

—Max Hochrein—(German working in
U. S. A. and Germany—

1932— Arthur Grollman—(U. S. A.)—Studies on cardiac output.

1933— Herrman L. Blumgart, Samuel Levine and David Berlin—(U. S. A.)—

Thyroidectomy in heart failure and angina pectoris.

1933—Adalbert v. Bogaert—(Belgian working in France)—Studies on chro¬
naxia of the myocardium and of tlie His bundle.

1933—Arthur Stoll—(Swiss)—Isolation of digitalis glucosides.

1933—Wilhelm Dressier—(Austrian)—Studies on pulsations of the chest wall;
studies on tricuspid stenosis.

1933— Charles Heymans—(Belgian)—Studies on the carotid sinus.

1934— Harry Goldblatt—(U. S. A.)—Experimental hypertension caused by renal

ischemia.

1935— Pedro Cossio—(Argentinian)—Book on Physical Diagnosis in Cardiology.
1935—Charles S. Beck—(U. S. A.)—Pectoral muscle implantation for relief of

angina pectoris.

1937—Hugo Roesler—(Austrian)—Textbook of Roentgenology of the Heart.
1937—Alfonso Castellanos—(Cuban)—Angiocardiography in children.

1939—Oscar Orias and Eduardo Braun-Menendez—(Argentinians)—Monograph
on Clinical Phonocardiography.

1939—Robert E. Gross—(U. S. A.)—Surgical ligature of patent ductus arteriosus.
1939 George P. Robb and Israel Steinberg—(U. S. A.)—Visualization of the
heart chambers in man.

As the above list shows, many different fields of Medicine have con¬
tributed to Cardiology. Anatomy has contributed the names of Botallo,
Vesalius, Morgagni, His jr., Keith and Flack, Tawara. Physiology
has contributed the names of Harvey, Landois, Ludwig, Chauveau,
Luciani, Stefani, Pachon, Starling, Tigerstedt, Rein, Hering, Wiggers,
Heymans, Fredericq, Grollman. Pathology is represented by Morgagni,
Virchow, Rokitansky, Cohnheim, Aschoff, Banti, Abbott, Moenckeberg,
Anitschoff, Rothberger, Scherf, Elias and Feller, and Goldblatt. Pharma¬
cology and Clinical Therapeutics are represented by Senac, Withering,
Lauder Brunton, Schmiedeberg, Wenckebach, Fraenkel, Straub, Mautner
and Pick, Loewi, and Stoll. Physical diagnosis advanced by merit of
Vesalius, Auenbrugger, Laennec, Skoda, Sahli, Cabot, Dressier and Cos-

160

ALDO A. LUISADA

sio. Real cardiologists can be called the following: Senac, Heberden,
Corvisart, Hodgson, Cheyne, Laennec, Corrigan, Bouillaud, Stokes,
Duroziez, Flint, Potain, Traube, Kussmaul, Galvagni, Oliver, Cardarelli,
Roger, Osier, Fallot, Steell, Bouveret, Eisenmenger, Broadbent, Morquio,
Wenckebach, Pal, Grocco, Fraenkel, Mackenzie, Libman, Vaquez, Arril-
laga, tierrick, Pardee, Laubry, Pezzi, Blumgart, S. Weiss, Levine, Wil¬
son, Edens, and White. Special techniques were either devised or applied
to Cardiology by Roentgen, Assmann, Bordet, Roesler, Castellanos, Robb
and Steinberg (Roentgenology); by Laennec, Frank, Wiggers, Orias
and Braun-Menendez (Auscultation and Phonocardiography); by
Einthoven, Wilson (Electrocardiography); by Marey, Mackenzie,
Wenckebach, Lewis, v. Recklinghausen, Vaquez, Laubry (Graphic
methods) ; by v. Basch, Riva-Rocci, Korotkow, Recklinghausen, Galla-
vardin (Blood Pressure); by Grollman (Cardiac output). Comparative
Biology is present in the person of Spitzer. The surgeons are well repre¬
sented by the names of Trendelenburg, Jonnesco, Brauer, Berlin, Beck
and Gross. Clinical Physiology shall be also recorded because of Luciani,
Murri, Blumgart, Soma Weiss and Levine.

This brief review demonstrates that Cardiology took advantage of
nearly all branches of Medicine and is still being perfected by contribu¬
tions from many of them.

Literature

(1) Castiglioni, A. Storia della Medicina, Milano, Soc. Ed. Unitas, 1926.

(2) Edens, E. Krankheiten des Herzens, Berlin, Springer, 1929.

(3) Herrick, J. B. A Short History of Cardiology, Baltimore, Thomas, 1942.

(4) Sigerist, H. E. Einfuehrung in die Medizin, Leipzig, 1931.

(5) Vaquez, H. Les Maladies du Coeur, Paris, Bailliere, 1928.

(6) White, P. D. Heart Disease, New York, Macmillan, 1937.

(7) Willius, F. A., and Keys, T. E. Cardiac Qassics, St. Louis, Mosby, 1941.

(8) Fischer, I. Biog^'aphisches Lexicon der hervorragender Aertze der letzten

fuenfzig Jahre, Wien, Urban and Schwarzenberg, 1933.

(9) Huebotter, F. H., and Vierordt, H. Biographisches Lexicon der hervor¬

ragender Aerzte aller Zeiten und Voelker., Wien, Urban and Schwarzen¬
berg, 1929.

DIABETIKERDIATEN DER VORINSULINARA
ADOLF MAGNUS-LEVY

Die jungeren Arzte von heute kennen aus eigener Erfahrung kaum
noch das Todesgespenst des voll ausgebildeten unentrinnbaren Comas,
die Zuckerkranken, deren Leiden nicht mehr als 20 Jahre zuriickreicht,
nicht mehr die Qualen und Entbehrungen, die die insulinlose Zeit den
armen Patienten vordem auferlegen musste. Dieser Aufsatz will, in
kurzer Ubersicht, die diatetischen Vorschriften der fiihrenden Kliniker
jener Epoche festhalten, in bewusster Beschrankung freilich auf die
Anfangsbehandlung der Schwerstkranken, wo es zunachst darauf ankam,
die Schwere des Diabetes zu brechen, eine gewisse Toleranz herbeizu-
fiihren, die Patienten zu erziehen. In diesen schwierigsten Verhaltnissen
kommen die Prinzipien der Behandlung und die ihnen unterliegenden
Vorstellungen scharfer zum Ausdruck, als in der anschliessenden
Dauerbehandlung oder in der der leichteren Falle.

Rollo hat, als erster, um 1800, den Zuckerkranken auf animalische
Kost verwiesen, bemerkenswerter Weise auf ranziges altes Fleisch, um
ihm ein Zuviel davon zu verleiden. Sein Andenken steht in verdienten
Ehren! Doch war ein Ausbau seiner Ideeen und die Befolgung seiner
Massnahmen in jenen friihen Jahren, aus mancherlei Griinden, nicht zu
erwarten gewesen; keine ununterbrochene Linie fiihrt von ihm in die
neuere Zeit, nicht einmal in England. Bouchardat nahm die Richtung
wieder auf, (seit etwa 1840; sein erstes Buch erschien 1851) “the most
brilliant clinician in the history of diabetes,” wie ihn Allen nennt. “ Fast
alle Einzelheiten moderner Behandlung finden sich bei ihm, der Ersatz
der KH durch Eiweiss und Fett, die Beschr^kung der Nahrung, gelegent-
liche Hungertage.” Sein “ manger le moins possible ” gibt in vier Worten
eine in jedem einzelnen Fall wirksame Vorschrift. Die Einfiihrung der
Gemiise, eines Brotersatzes (aus Gluten), die Empfehlung korperlicher
Arbeit gehen auf ihn zuriick. Bouchardat hat auch zuerst den Riickgang
des Diabetes in einer belagerten Stadt, Paris 1871, beobachtet und richtig
gedeutet. Doch lag die quantitative Denkweise und die Durchfiihrung
specialisierter Kuren dem franzosischen Genius weniger, als dem anderer
Nationen, auch die Kranken wiederstrebten strenger Behandlung.

Die allgemeine Durchsetzung moderner Behandlung kniipft an Cantani
an. Sein Buch iiber Stoffwechselkrankheiten erschien 1875, gleichzeitig

161

162

ADOLF MAGNUS-LEVY

mit Bouchardats zweiten Werk iiber Diabetes, es wurde sofort ins
Deutsche und Franzosische ubersetzt. Cantani, der Erzieher, verdankt
> seine Erfolge der rigorosen Durchfiihrung seiner strengen Vorschriften

durch viele, drei, sechs, und selbst neun Monate, zunachst unter voller
^ Klausur. Er erkannte die Notwendigkeit der Fleischbeschr^kung; seine

Patienten wurden erst beim Heruntergehen von 800 auf 500 g Fleisch
' zuckerfrei. Daneben gestattete er zunachst nur Fett, dies allerdings reich-

lich, daneben nichts anderes. Er machte von Hungertagen regelmassigen
Gebrauch, einmal wochentlich. Gemiise erlaubte er nicht friiher als zwei
Monate nach dem Verschwinden der Glykosurie. Anders als Bouchardat
war er ein Anhanger reicherer Kost, d. h. reicher Fettzufuhr. Um diese
zu erleichtern, scheute er sich nicht in spaterer Weiterbehandlung die KH
Toleranzgrenze zu iiberschreiten, wie das spater auch andere taten. Von
den Vorteilen korperlicher Arbeit ftir nicht zu schwer Erkrankte machte
auch Cantani Gebrauch. Ihr Nutzen wurde weiterhin zu allermeist
anerkannt.

In Deutschland waren in den 70er und 80er Jahren schon Manner wie
Seegen, Kuelz, Naunyn am Werk, und in manchen Kliniken hatte eine
leidlich rationelle Behandlung begonnen. Aber das Verstandnis fiir die
neuen Lehren war, wie auch in anderen vorgeschrittenen Landern, noch
auf enge Kreise beschrankt, die quantitative Betrachtung und Behandlung
kaum bekannt und wenig geiibt. Die Darstellung in Ziemssens grossem
Handbuch zahlt 1879 nur die “erlaubten, die bedingt erlaubten und die
verbotenen Nahrungsmittel ” auf, ohne jede Mengenangabe, ohne einen
einzigen Menuvorschlag und ohne Beriicksichtigung der Hohe der Glyko¬
surie. Arzte, die von Rollo oder Cantani gehort hatten, verordneten, oder
Kranke verzehrten auf eigene Faust Mengen bis zu 2 kilo Fleisch, 6 Eier
und wohl auch anderes. Es fehlte oft genug an jeder Kontrolle der
vorgeschriebenen Diat. Ein amiisantes Beispiel: der Assistent einer be-
deutenden, freilich nicht biochemisch gerichteten Klinik—er hat sich spater
einen guten Namen gemacht,—wollte 1878 den Einfluss von Medikamenten
auf die Zuckerausscheidung studieren. Dazu verordnete er seinen Kranken
eine, gewiss auskommliche, Diat mit etwa 130-150 gKH, 90gEusw.,
“ gelegentlich die H^fte mehr,” Es bekiimmerte sein arztliches und sein
Forschergewissen nicht, dass seine Patienten nie unter 4-500 g Z und
30-47 g N ausschieden, eine darunter wahrend 30 Tagen 5-800 g Z und
40-50 N, in einer anderen 24-tagigen Periode 700-1100 gZ und 60-76 gN
(entsprechend 4-500 g Eiweiss!).^ Eine grosse Zuckerausscheidung,
“ ein leichter Fall.”! Sie nahm, in jenen gliicklichen Tagen des Nahrungs-

Auf der Hohe ihrer “ Tatigkeit ” muss sie etwa 8000 Calorien “ genossen ” haben.

DIABETIKERDIATEN DER VORINSULINARA 163

iiberflusses, in 9 Monaten 10 kilo zu, und lieferte dafur der Klinik, gewiss
geme, 200 Kilo reinsten Traubenzuckers!

Auf dem Congress fiir innere Medizin 1886 kam die Cantanikur durch
Naunyn zu nachdriicklicher Empfehlung. Er folgte in mancher Hinsicht
den Bahnen seines Vorgangers, in der Begrenzung des Fleisches auf 500 g,
die auch er im Versuch als notwendig erwies, in dem Hinweis auf Fette,
denen er aber gleich von vorne herein etwas Gemiise und Friichte zulegte.
Hungertage waren auch ihm wichtig. Er trat der damals herrschenden
Cberfutterung energisch entgegen. Man hatte in jener Zeit zumeist einen
erhbhten Eiweiss- und Energiebedarf des Diabetikers angenommen.
Demgegeniiber zeigte Naunyns Schuler Weintraud, 1893, im Respirations-
und im Stoffwechselversuch, dass der Zuckerkranke mit der gleichen
Eiweiss und Calorienmenge, wie der Gesunde, mit 30 cal und manchmal
noch weniger, seinen Bestand durchaus behaupten konne. Diesen Stand-
punkt vertrat der Meister nachdriicklich. Immer wieder pragte er den
Arzten die Notwendigkeit der “ Schonung der Funktion” ein. Als das
Wesentliche der diabetischen Storung nahm er, seiner Zeit vorauseilend,
eine Dyszooamylie an, eine Unf^igkeit zum Aufbau des Glykogens.

Die Notwendigkeit KH weitgehend aus der Kost zuruckzudrangen,
war um 1900 schon allgemein anerkannt. Doch passierte es, dass ein
Ijeruhmter Physiologe, Schiff in Genf, ebenso wie ein heute vergessener
franzosischer Arzt, es ftir richtig hielt, den Zuckerverlust durch Aufnahme
zuckerbildender Nahrung zu kompensieren. So wurde sein leichter
Altersdiabetes rasch totlich.

Die dauernde Schonung der Funktion im Diabetes, die Naunyn den
arztlichen Praktikern eingescharft hatte, ist ein allgemeines Prinzip.
Albin Hoffmann, auch er ein Schuler des grossen Frerichs, hat auf dem
Gegensatz zwischen “ Ubung und Schonung der Organe ” als erster ein
Lehrbuch der allgemeinen Therapie aufgebaut. Das Wesen der Schonung,
cl. h. wie sie zustande kommt, konnte man in jenen Tagen, wo von dem
feineren Umsatz der Nahrungsstoffe und von dem morphologischen
Verhalten des Pancreas im Diabetes so wenig bekannt war, noch weit
weniger als heute feststellen. Fiir die Schadlichkeit der KH lag der
Nachweis ja nahe, fiir die der grossen Fleischrationen lag er gleichfalls
m ihrer Steigerung der Glykosurie (Cantani, Naunyn). Diese wurde
epater verstandlich, als man den Obergang gewisser Aminosauren in
Zucker erkannt hatte. Doch besteht die ungiinstige Wirkung iiberreich-
lichen Eiweissverzehrs sicherlich nicht nut darin. Dafur hatte man wohl
tin gewisses Gefiihl, ohne ihm jedoch nachgehen zu konnen. Fur die
Schadlichkeit grosser Fettgaben, die man nicht gut entbehren konnte.

164

ADOLF MAGNUS-LEVY

hat Allen spaterhin zu zeigen sich bemiiht, dass sie sich nicht in ihrer
Saureproduktion erschopfte (s. w. u.).

Kuelz (1874-98) hat durch exakte experimentelle Feststellung von
Tatsachen die Behandlung des Diabetes gxinstig beeinflusst, aber auf die
Diatetik keinen unmittelbaren Einfluss ausgeiibt. Er war Physiologe, nicht
klinischer Lehrer. Seine umfangreichen Erfahrungen am Krankenbett
warden erst nach seinem Tod von seinen Schiilem veroffentlicht.

Dem Blutsucker im Diabetes hatte man bereits im letzten Jahrzehnt
des vergangenen Jahrhunderts Aufmerksamkeit geschenkt. Die Mikro-
methoden Bangs (1914) und Folins ermoglichten spater seine fortlaufende

Bestimmung und fiigten so der Ausscheidung des Zuckers ein weiteres
wertvolles Kriterium zur Beurteilung seines Verhaltens im Organismus
hinzu.

Von Noorden hat mit seiner “Haferkur” (1902) die KH als einen

Icgitimen Bestandteil in die Diat auch der schweren F^le wieder einge-
ftihrt. Bis zu jenem Jahr folgte er im wesentlichen den “ klassischen ”
Bahnen, freilich mehr in den Spuren Catanis, als in denen Bouchardats
und Naunyns. Er trat im allgemeinen, und besonders beim Diabetes,

fur eine reiche Em^rung ein. Er lehnte, noch 1912, Weintrauds

Feststellung der Auskommlichkeit einer massigen Zufuhr fiir den Dia-
betiker durchaus ab, und war stark bemiiht, seinen Eiweissbestand zu
erhalten und aufzubauen. Machte man doch in den 90er Jahren eine

“ Abschmelzung ” von Korper eiweiss fiir mancherlei krankhafte Zustande
verantwortlich; man schrieb ihm einen vom Nahrungsprotein abweich-
enden Abbau, ja selbst einen “ toxischen Zerfall ” zu. So verlangte und
gab V. Noorden 40 cal pro ko, und mehr Eiweiss als die Klassiker
(zunachst “ bis 100 g,” nach Besserung bis 140 g) und ging nur selten
und kurze Zeit tief unter dieses Mass. Spater erkannte er die Be-
schr^kung des Eiweisses als einen Fortschritt an. An die Stelle der
Hungertage setzte er 3-4 tagige Folgen von Gemiisetagen mit sehr vid
Fett. Sie haben sich, mit nicht ganz so viel Fett belastet, sehr bewahrt
zumal in Verbindung mit KH Kuren.

Von Noorden kam auf seine “ Haferkur ” bei der Behandlung schwerer
Magendarmstorungen von Diabetikern mit diesem Nahrungsmittel. Der
erfreuliche Nebenerfolg bestand in einer uberraschend guten Ausnutzung
der St^ke und einem bedeutenden Riickgang der Acidose. In ihrer
urspriinglichen und von ihm lange festgfehaltenen Form bestand diese
“ Kur ” aus 3-4 Tagen mit 200-250 Hafergriitze, 200-300 Butter, etwas
Alkohol, und 100 g vegetabilischem Eiweiss. Animalisches Eiweiss war
streng ausgeschlossen. Also auch diese neue Diat eine kalorien- und

165

DIABETIKERDIATEN DER VORINSULINARA

eiweissreiche Kost, freilich eingeleitet und gefolgt von einigen Tagen
strenger Dial oder von Gemiisediat. In mehr oder weniger abgewandelter
Form sind KH Kuren zum integrierenden Bestandteil der diatetischen
Behandlung geworden. Kolisch forderte mit Recht eine starke Zuriick-
drangung der iibergrossen Eiweissgaben. Da ein spezifisch wirksamer
Stoff im Hafer nicht gefunden wurde, versuchte es L. Blum, 1911, mit
Weizenmehl, und andere nach ihm mit einzeln gegebenen weiteren
Cerealien. Falta baute auf deren giinstigen Erfahrungen eine “ gemischte
Amylaceendiat ” auf, meist in Suppenform gereicht. Im Wechsel mit
Gemiisedarreichung und einigen Tagen strenger Kost konnte diese
Behandlung viele Wochen durchgehalten werden.®

Bei den zweifellosen Erfolgen solchen gelegentlichen Wechsels der

Diat, obendrein mit gelegentlichen Hungertagen, ftihlt man sich fast an
die alte empirische Fruchtfolge mit Brache im Ackerbau frtiherer Zeiten
erinnert. Freilich ist die Kausalitat im Bereich des animalischen Lebens

weniger leicht zu erkennen als im Pflanzenreich.

Zwischen prolongierten KH Kuren und strenger vegetarischer oder
zumindesten fleischloser Kost ist der Unterschied nicht mehr gross.
Kolisch, Vertreter eines niedrigen Eiweissumsatzes, hat sich friihzeitig,

vor 1900, Stark fiir sie eingesetzt, Albu sich zustimmend gekssert, ohne

si’e wobi viel zu verordnen. Wirksam wird solche Kost zu einem Teil
durch ihren geringen Eiweissgehalt, zum anderen, wenn einigermassen
verst^dig gehandhabt, durch die mehr oder minder bewusste Erziehung

zur Massigkeit, die ja die meisten Anhanger jener Lebensweise tatsachlich

uben.

Ahnliches gilt auch, wofiir man heute mehr Verst^dnis hat als vor
40-50 Jahren, fiir gewisse einseitige Diatvorschriften empirischen Ur-
sprungs, wie Donkins Verordnung abgerahmter(!) Milch, fiir Duerings
“Reiskur” (1868), die iibrigens neben wenig Fleisch auch andere
Cerealien zuliess.® Er wollte ebenso wie Kolisch seine Patientin zu
einfacher und massiger Lebensweise erziehen.

* Mosses “ Kartoffelkur ” im Zusammenhang mit der Haferkur oftcrs besprochen, ihr
ubrigens zeitlich vorangehend (1898), ist keine KH Kur, wie die obigen, vielmehr eine
Dauerbehandlung mit gemischter Kost, in der die Starke des Brotes gegen die der
Kartoffeln ausgetauscht wurde. Er verschrieb 1500 g Kartoffeln, bei Fressern bis 3000.
Er hielt sie fiir besser assimilierbar als Brot. Wenn dabei die Zuckerausscheidung
herunterging, so wohl deswegen, weil auf die Dauer aequivalente Mengen von Kartoffeln
schwerer zu bew^tigen als 500 g Brot

'Dagegen hatte Karell, der, ein reiner Empiriker, seine beriihmte Milchkur 1866
beschrieb, und sie gelegentlich auch bei Diabetikem anwendete, diesen Zweck gar nicht
im Auge; er erkannte auch nicht, dass er seine Erfolge bei den verschiedensten Leiden der

166

ADOLF MAGNUS-LEVY

Auch daran ist bei den empirischen Spezialkuren von Arzten und Laien
einer friiheren Zeit zu erinnem, dass doch die Mehrzahl der Diabetiker—
wenn auch nicht immer der Behandelten—den leichteren Formen zuge-
horten, bei denen solche Kuren oft genug gewisse Erfolge aufzuweisen
batten, neben denen Misserfolge wohl nicht ausgiebig berichtet wurden.

Petren hinwiederum, von Erfahrungen Landergrens ausgehend, (von
1911 an, seine Monographie erschien 1921) blieb bei Fett und Eiweiss
allein, beim letzteren freilich mit allerstarkster Beschrankung, auf 20-25
g E (gleich 3-4 g N im Urin). Er hatte, bei versuchsweiser Verlangerung
der 4-6 Gemuse-Fett-Hungerperioden ausser einem Riickgang der Acidose
eine starke Abnahme der Hyperglyk^ie gesehen. Er wies, wenigstens
fiir sein Regime, eine “vollst^dige Unabhangigkeit des Grades der
Acidose vom verzehrten Fett ” nach, dagegen deutliche Beziehungen zum
Eiweissumsatz. Petren gab “in jedem(!) schweren Fall, auch wenn
derzeit ohne Ketosis,” nach anfanglichem 1-2 tagigem Hungern, sofort
200-250 g Speck und Butter, untergebracht in reichlichen Mengen (bis
1 ko) KH und E-armster Gemusen, dazu unter Umstanden weitere 30 g
Fett in Sahne. Diese Diat, unterbrochen nur (besser wohl “ gemildert”),
durch einen wochentlichen Hungertag, konnten er oder vielmehr seine
fettgewohnten Patienten, viele bis zu 10 Wochen, durchhalten. Erst
wenn der Blutzucker wenigstens 14 Tage bei 120 mg verblieben war,
wurden KH erlaubt. In dieser AuswaM der Fette konnte solche Kost
nur im kMteren schwedischen Norden zahlreiche Anhanger gewinnen.
Der Anblick von Petrens Kranken beim Verzehren von dick mit Butter
bestrichenen Gurken (Grafe) muss tatsachlich erstaunlich gewesen sein.

Newburgh und Marshs Verfahren (seit 1920) hat mit dem Petrens
die niedrigen Eiweissgaben gemein, es unterscheidet sich von ihm durch
eine anfangliche lange durchgefiihrte Unterernahrung, wahrend derer die
Kranken von ihrem eigenen Fett zehren mussten. Ohne jede Vorbereitung
durch Hungertage, setzten sie ihre Patienten sofort und amnahtnslos auf
“halbe Energierationen,” deren Hauptbestandteil das Fett ausmachte,
auf 15-20 gE, 85-95 Fett und 10-12 g Gemiise KH. Sie sahen dabei
ihre Kranken “schneller und sicherer zucker- und saurefrei werden als
durch Allens lange Fastenperioden,” die in Amerika ziemliche Verbreitung
gefunden batten. Nach erfolgter Entzuckerung sollte, in ausserst lang-
samer Steigerung eine Dauerdiat mit 30-40 cal pro ko angestrebt, dabei
das Eiweiss niedrig gehalten werden, mit 0, 67 g pro ko 40 g bei 60
ko Gewicht. Die Fettaufnahme gestalteten die amerikanischen Arzte

iippigcn Petersburger Gesellschaft der Unterernahrung verdankte. Er gibt ausdrucklich
an, nicht zu wissen, worauf sie beruhten.

167

DIABETIKERDIATEN DER VORINSULINARA

abwechslungsreicher und anziehender als ihr schwedischer Kollege
(Mayonnaise usw.).

Und abermals ein anderes Bild: Fr. Allen 1910, abweichend von
alien Vorgangern, im scharfsten Gegensatz zu Petren, dessen gleichzeitig
ausgebaute Methode ihm iibrigens 1910 noch unbekannt war. Er sah im
Diabetes nicht nur eine Storung des Stoffwechsels der KH, sondern
“a general disorder of nutrition,” wozu sie ja tatsachlich oft wird.
Insonderheit fiirchtete er die grossen Fettgaben, die kein Fruherer hatte
zuriickdrangen konnen. Lange Hungerzeiten, lange Unterernahrung,
relativ reichlich Eiweiss, relativ wenig Fett. Sein spartanisches Regime
hat Bouchardats Gebot ” manger le moins possible ” bis weit iiber die fiir
mbglich gehaltenen Grenzen durchgefiihrt. Sein leitender Gedanke war,
dass eine starke Gewichtsabnahme durch lange Unterernahrung auch im
Diabetes zulassig und geboten sei, da sie, entsprechend Chittendens Ver-
suchen am Gesunden, den Energiebedarf und damit die benotigten
Fettgaben absolut und relativ starkstens vermindere. Er zeigte dieses
und die Schadlichkeit iibergrosser Fettgaben in trefflichen Versuchen am
“ Sandmeyerhund ” mit partieller Pancreasextirpation. Eine knappe
Grundernahrung mit Lunge Hess die abgemagerten Tiere lange Zeit
bei trefflichem Befinden, Dauerzulagen von iiberreichlich Fett (180-
300 g! Schweineschmalz) verwandelten ihren leichten Diabetes in einen
schwerster Art, mit steigender Zuckerausscheidung, mit Lipaemie,
Acidosis und Tod im Coma.

Allen fuhrte eine einleitende Hungerperiode bei seinen Kranken bis zu
10 Tagen durch, ausnahmsweise noch langer, bis zu vollstandigem Ver-
schwinden der Glykosurie. Danach begann eine lange Unterernahrung
in langsamster Steigerung der Kost, bei den KH mit t%lichen Zulagen
von lOg GemiiseKH, grosser Zuriickhaltung mit Fett, dagegen schnellerer
Gew^rung von Eiweiss, mit dem er auch weiterhin liberaler sein musste,
bis nach Wochen und Monaten eine Erhaltungsdiat vertragen wurde.
Er rechnete fiir diese, bei einem abgemagerten Kranken von 50 kilo, mit
30 g Gemuse KH,—weit unterhalb der Toleranz,—mit 75 g Protein
(1, 5 pro kilo) und mit 1500 cal (30 pro kilo), deren Hauptmenge somit
von 120 g Fett geliefert werden musste. In einem seiner Menus waren
diese enthalten in 200 g Eiern, 100 Speck, 60 Fleisch, in 24 g Butter oder
Oel, 25 g Fettkase und 800 g KH armster Gemuse. Das Gesamtgewicht
dieser festen Speisen betragt nur 1200 g. Allen hat in Amerika und
England manche Anhanger gefunden, weniger in Deutschland, geschweige
denn in Schweden.

Adlersberg und Porges fettarme Diat moge hier angeschlossen werden.

168

ADOLF MAGNUS-LEVY

obgleich sie, 1926/28 entstanden, nur mehr mit leichteren und mittleren
Glykosurien zu tun hatte. Das heisst, sie gaben schwer Zuckerkranken
nur soviel Insulin, dass eine massige Zuckerausscheidung zunachst
bestehen blieb, leicht Kranke erhielten kein Hormon. Ihr Verfahren
“stiitzt sich auf eine Hypothese, die alle zu Toleranzsteigerung fiihrenden
Massnahmen einheitlich auf den Antagonismus von Glykogen- und Fett-
leber zuruckfiihrt.” Somit beschrankten sie, von anderen Vorstellungen
ausgehend als Allen, gleichfalls das Fett, auf das reine 30-40 g “dazu
den Gehalt der fettarm gemachten anderen Nahrungsmittel.” Dazu
kamen KH bis iiber die ursprungliche Toleranz hinaus und Protein in
einer “den Energiebedarf gerade deckenden,” also reichlichen Menge
(100-150 g); Eiweiss sollte die Fettauffiillung der Leber weniger begiin-
stigen als Fett. (Die empfindlicheren insulinbehandelten Falle erhielten
weniger Eiweiss, 60-80 g). Die Wiener Forscher erreichten so in vielen
Fallen eine allm^liche Steigerung der Toleranz. Grossere Fettzulagen
nach eingetretener Aglykosurie einige Zeit fortgegeben, fiihrten nicht
selten zu neuer Zuckerausscheidung, die “ gelegentlich nicht hinter der
nach aequivalenten KH Gaben zuriickblieb.” Gewiss eine Bestatigung
von Allens Gedankeng^gen und Experimenten.

Die Paradoxie, dass fast jede Combination der Hauptn^rstoflfe ihre
Vertreter und in vielen Fallen ihre Erfolge gehabt hat, kann und soil hier
nicht erortert werden. Der Historiker begnugt sich,—ob immer mit
Recht?, oft genug muss er es ja tim—“ aufzuzeigen, wie es gewesen ist.”
(L. Ranke) Weise Meister mussten nicht selten vom Prinzip und von
ihrem ursprunglichen Schema abweichen, und sie taten es. Es zeigte sich
sehr schon bei v. Noorden, der von 1885 an fast die ganze hier geschil-
derte Epoche und die Insulinzeit durchlebt und sie so stark beeinflusst hat.
Auch ist ein gewisser, freilich nicht sehr weitgehender Synkretismus. der
verschiedenen Richtungen allm^lich erfolgt. Sie gehoren dank Bantings
itnd Bests’ Auffindung des Insulins, die die grosse Entdeckung Merings
und Minkowskis kronte, der Geschichte an. Wie es vordem mit dem
Coma und seinen Schrecken ausgesehen hat, moge an zwei klassischen
Beschreibungen vergangeneur Tage hier festgehalten werden.

Kussmaul (1873): Eine Dyspnoe besonderer Art: nichts verrat hier,
wie bei den gewohnlichen Dyspnoeformen, dass die Luft auf dem Wege
zu Oder aus den Lungen auch nur das geringste Hindernis zu iiberwinden
habe; sie stromt im Gegenteil mit grosster Leichtigkeit ein und aus. Der
Brustkorb erweitert sich vortrefflich nach alien Richtungen, und den
vollkommenen Inspirationen folgen ebenso vollkommene Expirationen,
und doch weist alles auf den hochstgesteigerten Lufthunger hin usw.

DIABETIKERDIATEN DER VORINSULINARA 169

Frerichs (1883) : “Wer an Zuckerharnnihr leidet, wird stets bedroht
von der Gefahr eines plotzlichen und unerwarteten Todes. Er gleicht
einem miiden Wanderer, welcher in dichtem Nebel, auf schmalem Pfade
neben einem reissenden Strome einherschreitet, in steter Gefahr hinabzu-
stiirzen, wenn er angstlich seine Schritte beschleunigt, oder ein geringer
Unfall, ein Stein des Anstosses, ihm in den Weg tritt.”

Theorie u Therapie des Diabetes haben seit 80 Jahren die grossten
Fortschritte gemacht.

“UND SO FORTAN!”

Fleisch

(Eiweiss)

Fett

((^samtkalorien) Hunger

Rollo um 1800

ranzigl

Bouchardat

1840/Sl

“manger

le moins possible” 1

Cantani 1875

0 Gemuse

0 Obst

bis 500

reichlich

- l(-2)

Naunyn

1886-1900

Gemuse

Obst

bis 500

30 cal pro Ko

V. Noorden

1892-194?

Gemuse

Obst

100-140 E

40 cal pro ko

(jemusetage

V. Noorden

Haferkur 1902

vegetar. Kost
(Kolisch) vor

1900

> 150g

OFl

(100 veg. E)

sehr wenig

200F

Petren

1911-21

20-25g

1-2 nur im
Beginn

Newburg Marsh

1920

0,67 pro ko

30-40 cal
proko

lange Unter-
ernahrung

Allen (1910)

bei 50 ko

75 gr E (1, 5 E
pro ko)

Hunger bu
10 Tage

Adlersberg

Forges

uber

Toleranz

100-150 E

4 0 + X ; wenig 1

1926

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA

COLONIAL

CARLOS MARTINEZ DURAN
I

El Hospital, Creadon Cristiana y Espahola en America

Esta demostrado que los pueblos aborigenes de America no tuvieron
hospitales. Su civilizacion inferior, sus conceptos religiosos, eran des-
favorables para la creacion de asilos para enfermos y desvalidos, obras
esencialmente caritativas en su origen, nacidas al amparo del cristianismo.
En el Diccionario Universal de Historia y Geografia, publicado en Mexico
en el ano de 1856, por Don Manuel Orozco y Berra se afirma, sin aducir
ninguna prueba historica, que los indios aztecas poseian hospitales en
Mexico y Cholula. Esta afirmacion, producto como tantas otras, del afan
sobrestimador de la cultura indigena, esta renida con la verdad historica.
Y lo prueba el mismo Orozco y Berra, quien ahade despues, que s61o la
caridad cristiana y una civilizacion mas avanzada que la de los aztecas,
pudieron establecer instituciones hospitalarias. No sabemos que en nin¬
guna otra historia de los pueblos amerigenos, se haya intentado decir que
los indios poseian hospitales organizados y bien atendidos. Es por lo
tanto, verdad innegable, que el Hospital fue obra de la conquista espanola
de America.

El cristianismo, por sus alcances universales y humanos, por el amor
a Dios y al projimo que fundamenta su doctrina, elevo el hospital a la
categoria de obra piadosa. prestandole toda clase de ayudas, lo cual per-
mitio su progreso material y espiritual, base segura para su porvenir
cientifico.

Si bien es cierto que antes de la era cristiana existian hospitales, estas
instituciones no llegan a su perfeccion sino hasta el ano 1000, gracias al
progreso del cristianismo y a la Orden de los Caballeros Hospitalarios de
San Juan de Jerusalem.

El emperador Asoka fundo en el Indostan, 260 ahos antes de Jesucristo,
un hospital, que posiblemente sea el mas antiguo del mundo. En el siglo
II de nuestra era, el emperador romano, Adriano, fund6 un hospital
militar. En el ano 380, Fabiola fundo en Ostia un grande y bien or-
ganizado hospital.

En el aho 580, el Obispo Mansona fund6 en Merida el primer hospital

170

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 171

que conocio Espana. Todos estos hospitales iniciaron la piadosa obra
de recoger enfermos para darles asilo, alimentacion material y espiritual,
medicinas segun la epoca.

Son los Caballeros Hospitalarios los verdaderos creadores y reforma-
dores del hospital, como institucion cientifica y organizada. Gracias a
ellos, la Medicina recibio estimulo y progreso. La contemplacion sis-
tematica del dolor humano, la fe que se ponia en aliviarlo, la necesidad
de organizar una asistencia eficaz, pronta y bien organizada, impulsaron
los estudios medicos, haciendolos progresar en el sentido cientifico y en
sus aspectos humanitarios y sociales.

Ya el sajon Edgar Erskine Hume ha consagrado en profunda y justa
monografia la obra hospitalaria del Cristianismo, y se queja muchas veces,
al contemplar la maravilla del hospital moderno, actual, rico en ciencia,
pobre en caridad. Todos los hospitales de America nacieron bajo el signo
del cristianismo, eje y suprema razon de la Conquista Espanola.

Aun no hemos estudiado, con el detenimiento requerido, el valor que
representa el hospital en la conquista de America. Institucion cara al
conquistador y al misionero, es factor interesante en la vida material y
espiritual de los indios.

El hospital no tiene solo valor etico en la conquista espanola. Tiene
un gran valor social y cientifico. En sus salas, los medicos y los cirujanos,
espanoles, criollos y mestizos, aprendieron la trascendencia social de la
Medicina, encontrando y descubriendo mas de una vez, en presencia del
dolor ajeno, la medicina cientifica. Es en las salas hospitalarias donde
progreso el medico y la Medicina de America, pues en la catedra uni-
versitaria, no siempre se admitia la novedad, y muy a menudo, triunfaba
con exclusivismo intransigente, la vieja doctrina de libros mas viejos aun.
Toda la Medicina moderna de la America Espanola es oriunda del hos¬
pital. Nuestros medicos y cirujanos coloniales recibieron en las salas
hospitalarias sus mejores lecciones, alii formaron su experiencia, y frente
a la realidad tragica del lecho miserable, surgio la agudeza diagnostica,
la luz del mejor conocimiento, la eficacia de la medicina verdadera y
cientifica.

La fundacion de hospitales por conquistadores y misioneros, es una de
tantas pruebas para conocer y afirmar el contenido espiritual de la con¬
quista espanola.

Es la fuerza espiritual de la conquista, lo universal de sus alcances,
lo que mueve a guerreros y frailes, y por ello mismo, lo que sale de Espana
es la flor de la peninsula. Lo mejor en sangre y espiritu. Sangre y espiritu
que amasaran vida e historia, porque el espanol crea su vida y su historia.

172

CARLOS MARTInEZ DUrAn

La vida y la historia de los hospitales coloniales de America, van ligadas
estrechamente a la personalidad del conquistador que los funda, y al
espiritu de Obispos y Ordenes Religiosas que los administran y guian.

Al hacer la cronologia de los hospitales coloniales de America nos
sorprende su mimero y sus actividades. El hospital tiene en la fundacion
de la ciudad, sitio importante, y junto a la Iglesia y a la Escuela, va a
surgir noble y piadoso. Y asi, la flor de la Caridad se eleva para completar
la sabiduria de Dios, que triunfa en la Catedral y en la Escuela Misionera.

Origen, Desarrollo, Organizacion y Decadencia de los Hospitales
Coloniales de America

Puede asegurarse que la fundacion de hospitales era hecho paralelo a
la fundacion de todas las ciudades coloniales de America. Los Conquista-
dores, al trazar las ciudades, sehalaban sitio para la fabrica del hospital.
Algunos de ellos, tal el caso de Hernan Cortez, dedicaron especial devocion
y fuertes sumas de sus rentas para el progreso de las santas casas, recien
fundadas. Mas tarde, cuando la ciudad llegaba a su florecimiento, y pre-
lados, misioneros, virreyes o capitanes, impulsaban artes, ciencias e in-
dustrias, cada uno de ellos consagraba interes y rentas para las obras de
misericordia, representadas en asilos, hospicios y hospitales.

Estos afanes filantropicos derivan directamente del profundo sentido
cristiano de la conquista espahola. El origen del hospital va asi ligado
directamente a los ideales y fines de la colonizacion espanola, que ajena
a mercantilismos u otros intereses materiales, lleva como finalidad su-
prema y sublime, una realidad espiritual, un apostolado etico, una grandeza
religiosa y cultural.

Los indios pobres y enfermos, que nunca conocieron en su rudimentaria
civilizacion los dones de la caridad, encontraron en el hospital un refugio
confortable y carinoso. La Corona Espanola, siempre atenta a todo lo
que haeia mejorar y progresar sus dominios de Ultramar, logrando la
felicidad de sus nuevos subditos, dicto numerosas leyes y utiles recomen-
daciones para la fundacion y crecimiento de los hospitales coloniales.

Una de las leyes de Felipe II establecia lo siguiente: “ que cuando se
fundare o poblare una ciudad, villa o lugar, se ponga los hospitales para
pobres y enfermedades que no son contagiosas, junto a las iglesias o
claustros de ellas, y para los enfermos de enfermedades contagiosas en
lugares levantados y partes que ningun viento danoso, pasando por los
hospitales vaya a herir en la poblacion.”

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 173

Esta ley, inspirada en la poHtica sanitaria y social, fue seguida en todas
las ciudades coloniales.

Casi todos los hospitales del centro y de las afueras de la ciudad, fueron
fundados y construidos durante el siglo XVL En el siglo XVII se
ensancharon y mejoraron las fabricas, se aumento el numero de camas,
se mejoro la asistencia medica y se multiplicaron las rentas que los
sostenian.

Un gran numero de los hospitales coloniales estuvo sujeto a las mas
variadas y tragicas circunstancias. Terremotos frecuentes, inundaciones
e incendios destruian los edificios e impedian las nuevas construcciones.

A pesar de todas estas calamidades, el espiritu fuerte, constante y
generoso de los espanoles y mestizos triunfo f)or doquiera, y los hospitales
resurgian nuevos y mejores.

Los hospitales mas importantes del siglo XVI fueron 23. Todos ellos,
a pesar de sus tragedias, subsisten en la actualidad. Algunos, como el
fundado en Mexico por Hernan Cortez, se presentan intactos, y albergan
en sus viejos muros y salas, toda la modernidad de un hospital con-
temporaneo. Otros, viven en la soledad de sus ruinas, mudo testimonio
de lo que fueron. Y otros mas, desaparecidos completamente, solo se
perpetuan en el nombre conservado o en el sitio donde fueron edihcados
originalmente.

Lo esencial en la vida de estos hospitales coloniales es, que al cabo de
sus cuatro siglos de existencia, su historia y su tradicion gozan del fuero
de la inmortalidad. No importa que la fabrica material haya desaparecido,
inutil ya para su vida cientihca, no importa que las ordenes religiosas ya
no los administren, lo que importa es lo trascendental de su espiritu,
etemo en sus normas. Viejo o nuevo, atrasado o avanzadisimo, el hospital
nace de la caridad cristiana. La ciencia que lo anima en la actualidad vive
y vivira bajo la egida moral que nos ensena: “ Aliviar el dolor, es obra
divina.”

Los hospitales coloniales han asistido por cerca de cuatro siglos, a todos
los progresos de la Medicina.

Los hospitales coloniales eran de varias clases y se sujetaban a las leyes
reales dictadas al respecto. Los hospitales generales casi siempre estaban
situados cerca de la plaza mayor o en lugar no distante de lo urbano.
Se asistia en ellos a enfermos de ambos sexos, en salas separadas. Los
espanoles, criollos o mestizos tenian a veces hospitales propios, y en tal
caso, los indios poseian su hospital i 'idependiente, situado en barrios sub-
urbanos.

Estos hospitales generales, a pesar de sus variantes, se construian de

174

CARLOS MARTInEZ DURAN

acuerdo con pianos mas o menos similares. El hospital, (veanse grabados)
se componia de dos cuerpos: las enfermerias y la capilla o iglesia cir-
cundada por el convento de los religiosos administradores. Algunas de
estas iglesias fueron grandes y hermosas, lo mismo que los conventos que
alojaban a los religiosos. Las enfermerias ocupaban casi siempre un gran
cuadrilatero con patio central de grandes dimensiones, en cuyo centre
florecian jardines y no faltaba la consabida fuente de piedra. Cuatro
corredores amplios limitaban el patio, los cuales se disponian en arcadas.
A veces, en tierras no expuestas a los terremotos, los corredores eran de
dos pisos, con majestuosas arcadas. Las enfermerias eran grandes salones
abiertos a los corredores por altas puertas. Los muros exteriores poseian
altas ventanas, relativamente estrechas. Algpinas enfermerias estaban
dispuestas en crucero para permitir el altar cristiano interior. En cuanto
al numero de camas, es imposible fijar la cantidad, pues ello dependia de
las rentas y progresos hospitalarios.

El sostenimiento de los hospitales generales, llamados corrientemente
de San Juan de Dios, dependia de variadas rentas. Poseian rentas reales
fijas o bien rentas procedentes de magnanimas familias o piadosos prelados
que realizaban la caridad cristiana en obras tan piadosas como el consuelo
y alivio de enfermos.

Ademas de los hospitales generales existian en todas las ciudades los
hospitales de San Lazaro, destinados a los leprosos. Estos se construian
en las afueras de la ciudad, poseyendo proporciones modestas.

Gracias al Venerable Hermann Pedro de Bethencourt y a la Orden
Betlemitica se erigieron en America, durante los siglos XVII y XVIII,
los hospitales llamados de Convalecientes de Nuestra Senora de Belen.
Estos hospitales, construidos bajo las mismas bases de los otros, Servian
exclusivamente para dar asilo a los convalecientes, que al salir del hospital
carecian de techo y de fuerzas necesarias para emprender de nuevo la vida
de trabajo diario.

Otro de los hospitales que nunca falto en las ciudades coloniales, fue
el llamado de San Pedro, destinado exclusivamente para los eclesiasticos
pobres y enfermos, sostenido con rentas propias de la Iglesia.

Hubo ademas muchos otros hospitales u hospicios destinados a pes-
tiferos, a peregrinos, y a mujeres caidas en la miseria.

Esta numerosa y variada cantidad de hospitales muestra al historiador
lo completo, profundo y trascendental del contenido cristiano de la con-
quista espanola. La Corona Espanola y todos los gobernadores reales y
eclesiasticos de la America Hispanica mantuvieron una constante pro-
teccion social y cientifica para pobres, enfermos y desvalidos.

175

Ruinas del Hospital Real de Santiago. Antigua Guatemala.
Fundado en 1559.

Plano del Hospital Real de Santiago, Antigua Guatemala.

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 177

Descrita ya la arc|uitectura y clases cle los hospitales cle America durante
la Colonia, pasamos a describir someramente bajo (jue formas se hacia
V comprendia la asistencia y cuidado de los cnfermos.

Lo (jiie iKKiriamos llamar medicina cientifica de la epiKa, desde luego
atrasada y sujeta al iiensamiento universal de aquellos tiempos, tstaba
encorncndada en el hospital a los medicos universitarios, a los cirujanos
y a los barberos. Durante cl siglo XVI, los medicos universitarios pro-
cedian de las mejores universidades espanolas, mas tarde, al crecer nuestras
itniversidades. los medicos fueron criollos o mestizos, algunos de ellos,
con grandes capacidades y meritos autenticos, (juizas superiorcs a lo quc
los tienqxis exigian.

Kstos medicos pasaban visita diariamente, acompanados del enfermero
mayor, religioso de alguna orden. En algunas ciudades, un solo medico
tenia (|ue atender los dos o mas hospitales existentes.

Al jiasar la visita diaria, el medico llevaba un libro de recetas que
dcbian ser confeccionadas en la Ixjtica anexa al hospital. Esta Ixjtica,
manejada iK)r religiosos o ix)r boticarios examinados en el arte farma-
ceiitico, fue siempre de|)endencia muy importante en los hospitales.

Los medicos ganaban un sueldo regular, fijado anualmente.

El cirujano. cpie a menudo se hacia llamar protocirujano de los hos¬
pitales. compartia con el medico las graves res|K)nsabilidades que ocasiona
el dificil arte de curar.

El barbero mayor del hospital, examinado y aprobado, tenia a su cargo
la e.xtraccion de las muelas y la practica de las sangrias; como estas eran
muy frecuentes y copiosas, los barberos flebotomos abundaban en trabajo
constante.

Medico, cirujano y barbero constituian la trinidad cientifica o empirica
(le los hospitales de la Colonia.

El cuidado constante, la alimentacion y la ejecucion de las recetas
medicas estuvieron a cargo de los hermanos religiosos que administraban
lc)s hospitales. Dos ordenes religiosas polarizaron en America la adminis-
tracion de los hospitales. La Orden de los Hermanos Hospitalarios de
San Juan de Dios, fundada jxir el portugues Juan de Dios en un hospital
(le (iranada (Espana^ y aprobada por el Papa San Pio V, en el ano de
L'i72; y la Orden Hospitalaria de Religiosos de Nuestra Senora de Belen.
fundada en Guatemala jxir el Venerable Hermano Pedro de Bethencourt
y ix)r Pray Rodrigo de la Cruz, en la segunda mitad del siglo XVII.
-A Guatemala cujxi el honor de ser la cuna de una Orden Hospitalaria,
cuyos inmensos beneficios fiorecieron en muchos hospitales de America,
e.s|xx:ialmente en los de la America del Sur. Los hermanos hospitalarios

Fig. 4.

Venerable Hermano Pedro de Bethencourt, fundador del
Hospital de Convalecientes en la Antigua Guatemala,
y de la Orden Betlemitica-

178

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 179

betlemitas usaban habito semejante al de la Orden Tercera Franciscana,
Ilevando en el brazo un escudo con San Jose la Virgen Maria y el Nino
Dios. Usaban tambien—grandes barbas, y por ello fueron bautizados con
el nombre de hermanos barbones. Los hermanos de San Juan de Dios
eran llamados juandedianos y usaban un habito negro. Existian tambien
otras ordenes religiosas menores, como la de los hermanos de San Hipolito
y otras, que desde luego no tuvieron mayor importancia en la historia de
nuestros hospitales.

Las Ordenes Religiosas Hospitalarias han sido criticadas severamente,
y muchas veces se les atribuye a ellas la causa del retraso cientifico de los
hospitales. Este injusto y erroneo juicio deriva como tantos otros, de la
costumbre de juzgar los hechos pasados con criterio moderno, sin tomar
en cuenta las condiciones naturales de la epoca.

Las Ordenes Hospitalarias creadas con profundo sentido cristiano
realizaron en heroico sacrificio hermosas virtudes. Cuidaron a los en-
fermos con esmero y puntualidad, consagrandose totalmente a ellos,
renunciando a todos los placeres de la vida. Al estudiar detenidamente
la vida hospitalaria encontramos a cada instante hechos que demuestran
la buena intencion de los hermanos hospitalarios, que mas de una vez
construyeron y reformaron, fieles al progreso, las santas casas hospitalarias.

La decadencia de los viejos hospitales iniciose alfinalizar el siglo XVIII.
Nuevas tendencias en la Medicina iban a modificar la vida hospitalaria,
que encuentra su verdadero camino hasta el fin del siglo XIX.

Los viejos hospitales no murieron. En sus viejos muros, el arte de
curar resurgio cientifico y luminoso. Cambiaron las escuelas medicas y
las organizaciones hospitalarias, y sin embargo, el viejo hospital colonial
sigue ensefiandonos las virtudes cristianas, y mostrandonos a toda hora
la nobleza, uncion y sacrificio que los medicos debemos practicar en la
curacion de los enfermos.

Los hospitales coloniales de America son una magnifica herencia, y la
tradicion de su espiritu generoso goza del incomparable fuero de la
inmortalidad.

Ill

Cronologia de los Hospitales de la America Hispanica Durante
la Colonia

En esta cronologia figuran los mas importantes hospitales que se
fundaron en America durante la epoca colonial, en los siglos XVI, XVII
y XVIII.

La lista cronologica es bastante completa. Sin embargo, faltan algunos

180

CARLOS MARtInEZ DURAN

hospitales, cuya fecha de fundacion no pude obtener, a pesar de haber
consultado numerosa bibliografia. Sin duda alguna, en Caracas, Venezuela,
existieron hospitales en los siglos XVI y XVII. En las obras de Rodriguez
Rivero, muy completas y extensas, no hay ningun dato acerca de la funda¬
cion de hospitales. No habiendo podido obtener esos datos, lamento no
incluir en mi cronologia los hospitales caraquenos.

En Colombia y en Cuba casi no se ha escrito sobre historia medica
nacional. For tal motivo, solo pude obtener datos sobre unos cuantos
hospitales fundados en los siglos XVII y XVIII. Es indudable que en
estos paises existieron hospitales en el siglo XVI.

Hechas estas salvedades para justificar las omisiones incurridas en mi
cronologia, espero completarla mas tarde.

Hospitales del Siglo XVI

Primer hospital de America. Aho de 1502. Fue fundado en Santo
Domingo, ciudad principal de la Isla Espahola, por Fray Nicolas de
Ovando, en el ano de 1502. Se llamo Hospital de San Nicolas de Bari
y fue construido con dinero perteneciente al propio fundador. Poseia
varias salas para enfermos. Existen pianos de este hospital, cuyas ruinas
aun pueden verse.

Segundo hospital de America. Aho de 1524. Fue fundado por Hernan
Cortez en Mexico. Este hospital es el mas importante de todos, pues a
pesar de sus cuatro siglos de vida, existe parcialmente intacto, y presta
en la actualidad modemisimo servicio.

Este hospital, llamado de Jesus Nazareno o de la Purisima Concepcion,
fue edificado en el sitio donde se encontraron por primera vez el con¬
quistador Hernan Cortez y el Emperador Moctezuma. Fue dirigida la
construccion p)or el arquitecto espanol Pedro de Vasquez. La obra quedo
terminada en 1535, pero desde sus primeros anos funciono asilando
enfermos.

Tercer hospital de America. Aho de 1527. Fue fundado por D. Jorge
de Alvarado, hermano del conquistador de Guatemala, en la ciudad de
Guatemala del ^^alle de Almolonga. Se llamo Hospital de la Misericordia.
No se construyo inmediatamente. Funcionaba ya en 1535, y fue destruido
en 1541, al arruinarse la ciudad por violenta inundacion.

Hospital Real de San Jo.<!e de los Natnrales. Aho de 1530. Fundado
en Mexico por Fray Pedro de Gante, en el ano de 1530.

Hospital de Santa Fe para Indios. Aho de 1531. Fundado por Vasco
de Quiroga, en 1531, para indios, en las afueras de Mexico.

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 181

Hospital Real de las Bubas o del Amor de Dios. Ano de 1534. Fundado
en Mexico por el Obispo Zumarraga.

Primer Hospital de Lima, cerca del Convento de Sto. Domingo. Ano
de 1538. Fundado por el conquistador Pizarro y el Primer Cabildo de
Lima.

Hospital de Nuestra Senora de Belen del Perote. Ano de 1540. Fundado
por Fray Julian Garces, Obispo de Tlaxcala, para viajeros y peregrinos
enfermos que llegaran al Puerto de la Veracruz.

Primer Hospital del Brasil, en Santos. Ano de 1543. Lo fundo el
hidalgo portugues Braz Cubas, en 1543. Lo llamo Santa Casa de Miseri-
cordia de Santos, a semejanza del que existia en Lisboa. Este hospital
dio el nombre al puerto. (Santos) y fue confirmado por el Rey Juan III
en el ano de 1551.

Hospital Real de San Andres. Ano de 1545. Fundado por Fray
Francisco de Molina, en Lima, para espanoles. El fraile fundador le
heredo todos sus bienes al morir.

Hospital de Santa Ana. Ano de 1549. Fundado en 1549 por el primer
obispo de Lima, Fray Geronimo de Loayza, y destinado a indios enfermos.

Hospital de Nuestra Senora de los Remedios. Ano de 1553. Edificado
en Guatemala del Valle de Panchoy. Convertido mas tarde en Hospital
Real de Santiago.

Hospital de San Ale jo. Ano de 1553. Fundado en Guatemala del Valle
de Panchoy por el dominico Fray Matias de Paz. Confirmado por Cedula
Real de 1553. Hospital destinado exclusivamente a indios.

Hospital del Socorro. Ano de 1556. Fundado en Santiago de Chile.
Mas tarde llamado de San Juan de Dios.

Hospital de la Sant'isima. Aiio de 1557. Fundado en Mexico por el
clero secular.

Hospital Real de Santiago. Aho de 1559. Fundado en Guatemala del
Valle de Panchoy por el primer Obispo Lie. Francisco Marroquin. Actual-
mente existen sus ruinas. (Vease grabado.)

Hospital de San Bartolome. Aiio de 1561. Fundado en Lima para
mulatos y negros.

Hospital de San Ldzaro. Aiio de 1563. Fundado en Lima por el espanol
Anton Sanchez. Este hospital de leprosos es el primero que se fundo en
America.

Hospital de la Misericordia de Nuestro Seiior Jesucristo. Aiio de 1565.
Fundado en Quito (Ecuador) por Hernando de Santillan.

Hospital de San Ldzaro. Aiio de 1572. Fundado en Mexico por el
medico Pedro Lopez.

182

CARLOS MARTInEZ DUrAn

Primer Hospital de Cordoba. Argentina. Ano de 1576. Fundado bajo
la advocacion de Santa Eulalia, por D. Lorenzo Juarez y Figueroa.

Hospital de Monserrat para pestiferos. Ano de 1580. Fundado en
Tacubaya, Mexico, por los aragoneses Diego Jimenez y Fernando Moreno.

Hospital de N. Senora de los Desamparados. Ano de 1582. Fundado
en Mexico por el m^ico Pedro Lopez para mulatos y negros.

Hospital de la Santa Casa de Misericordia. Ano de 1582. Fundado en
Rio de Janeiro por el hermano Jose de Anchieta. Reconocido en 1605,
por edicto del Rey Felipe II.

Hospitales del Siglo XVII

Hospital de San Juan de Dios. Ano de 1618. Fundado en Guayaquil.
Tuvo vida muy accidentada, sin rentas reales ni locales.

Hospital de San Lazaro de Guatemala. Ano de 1628. Fundado por
el Capitan General D. Alvaro de Quin6nez Osorio, Marques de Lorenzana.
Se empezo a edificar en 1640.

Hospital de San Pedro de Guatemala. Aiio de 1646. Destinado a
eclesiasticos pobres y enfermos. Fundado por el Obispo Bartolome
Gonzalez Soltero.

Hospital de Convalecientes de Nuestra Senora de Belem. Ano de 1660.
Fundado en Guatemala por el V. Hermano Pedro de Bethencourt. Primer
hospital de esta clase en America. Del seno de este hospital surgio la
Orden Betlemitica.

Hospital de San Lazaro de la Hahana. Aiio de 1661. Fundado en la
Habana por D. Pedro Alegre, quien dono su capital para la edificacion.

Hospital de San Francisco de Paula. Aiio de 1665. Fundado en la
Habana por el Presbitero Nicolas Estevez y Borges.

Hospital de Convalecientes de N. Sra del Carmen. Aiio de 1668. Fun¬
dado en Lima por Antonio Davila y administrado por los betlemitas.

H os pit ales del siglo XV HI

Hospital de Convalecientes de N. Sra. de Belem. Ano de 1705. Fun¬
dado en la Habana por el Obispo Avelino de Compostela.

Hospital de Jesus, Marta y Jose, despues de San Juan de Dios. Ano
de 1739. Fundado en Santa Fe de Bogota por el bogotano Fray Pedro
Pablo de Villamor.

Hospitales del Rey: de la ciudadela, de la tropa
1750-1751-1756. Fundados en Montevideo.

Segundo Hospital de Cordoba u Hospital de la

y marina. Anos de
Asuncidn y de San

LOS HOSPITALES DE AMERICA DURANTE LA EPOCA COLONIAL 183

Roque. Ano de 1762. Fundado por el Obispo Salguero, terminado en
1799, administrado por los Betlemitas.

Hospital Civil de Montevideo, Uruguay. Ano de V78. Fundado por
Mateo Vidal.

Hospital de San Borja para epidemias. Ano de 1782. Fundado en
Santiago de Chile por el Cabildo.

Hospital de Mujeres de Cordoba. Ano de 1792.

BIBLIOGRAFIA

Documentos de los Archives de Guatemala. Seccion Hospitales. El primer Hospital
de America. F. A. Batlle. Revista Medica Dominicana. Recordatorio:
Dr. Francisco Asturias. Guatemala. 1943.

El Hospital de Jesus Nazareno. Edgar Erskine Hume. Gaceta Medica de Mexico.
Agosto de 1938.

Medical Work of the Knights Hospitallers of Saint John of Jerusalem. Edgar
Erskine Hume. Baltimore, Johns Hopkins Press, 1940.

Nueve siglos de trabajos medicos y de beneficencia de los Caballeros Hospitalarios
de San Juan de Jerusalem. J, J. Izquierdo. Gaceta Medica de Mexico.
Febrero de 1942.

Historia de la Medicina en Mexico. Dr. Fernando Ocaranza.

Historia de la cirugia mexicana. Dr. Fco. Fernandez del Castillo.

Las Ciencias Medicas en Guatemala. Origen y evolucion. Dr. Carlos Martinez
Duran. Guatemala. Noviembre de 1941.

Cuatro Siglos de Medicina Limense. Dr. C. E. Paz Soldan. Lima. 1935.
Terremotos, epidemias y Hospitales de Lima colonial. Dr. J. B. Lastres. 1940.
Cuatro siglos de medicina bogotana. Luis Augusto Cuervo. 1938.

Historia de la Medicina en el Urugruay. Dr. Rafael Schiaffino.

Hospitales coloniales. Jose Luis Molinari. Argentina. Buenos Aires.

Historia de la Medicina en Cordoba. Felix Garzon Maceda. Cordoba. 1916.
Historia del Hospital de San Roque. Dr. Obdulio Trucco. Cordoba. 1939.
Diccionario de Historia y Geografia. Manuel Orozco y Berra. Mexico. 1856.
Publicaciones de la Catedra de Historia de la Medicina. Dr. Juan Ramon Beltran.
Buenos Aires. Tomo. IV, 1940.

Historia de la Medicina en Guayaquil. Dr. Gabriel Pino y Roca. 1915.

Historia de la Medicina en Cuba. Paginas ineditas del Dr. Saturnino Picaza.

Memorias del Primer Congp-eso Medico de Santos, Brasil. 1936-38.

El Protomedicato en Chile. Tesis inaugural. 1928. Dr. Ricardo Benavente Garces.
Evolucion de la Medicina en el Ecuador. Dr. Gualberto Arcos. 1938. Quito.
Obras medico-historicas del Dr. Rodriguez Rivero. Caracas, Venezuela.

MIGNOTYDEA

An Undescribed Epidemiological Monograph of the
CiNQUECENTO

CLAUDIUS F. MAYER

From the earliest years of its history the Italian peninsula has been the
favorite land of epidemics, which were usually preceded by poverty, famine
and war, and the hungry malnourished population fell an easy victim.

The common people of Christian Europe thought that pestilence—a gen¬
eral term for all epidemic diseases—was the whip of God. Western physi¬
cians felt that, since pestilence was thought to be primarily a disease
brought on by noxious air, not much could be done for its prevention and
treatment beyond what Galen and the Arabs advised.

After the great plagpie, the black death of 1346-1350, a general interest
arose for a new study of pestilence. In Italy, the 15th and 16th centuries,
with their periodic waves of epidemics, offered many opportunities for
such studies which gradually led to the separation of well-defined diseases
from the collective syndrom of pestilence. It was the 16th century, the
Italian Cinquecento, which distinguished and described the scarlet fever,
the typhus fever, the influenza, and many other separate units of acute j

contagious disease, for which the chief merit belongs to Italian physicians. j

Sixteenth century Italy was many times visited by the “ epidemia ” or j

“ pestis.” Periodically it assumed pandemic proportions, and swept the
land from one end to the other. Five such periods of pandemic can be |

distinguished: 1) 1501-1511; 2) 1521-1530; 3) 1550-1558; 4) 1574- i

1577; 5) 1591-1593.^ (:

It is the period of the second pandemic pestilence in Italy which in 1524 I

finds its way to the Po valley and, along the Sesia river, to the town of ||

Varallo where Giammaria Mignoto (Johannes Maria Mignotus), the [

author of a little known epidemiological monograph, was living and
practising medicine. fi

Little can be found on this physician, his personal or family life. De

^ De Renzi’s dates are slightly different: 1) 1502-6; 2) 1522-9; 3) 1550-8; 4) 1574-7;

5) 1591-3. (Cf. his Storia, v. 3, p. 573 ff.) During the first pandemic, Giorgione died
in 1511; during the second, Perugino died in 1523; during the fourth, Tizian died in
1576. This was the most severe, an epidemic of true plague, and is universally known
by the humanitarian efforts of Carlo Borromeo, archbishop of Milano, in 1576.

184

MIGNOTYDEA

185

Renzi states that Mignoto was of Piodi, a village in the Valsesia. An
uncle of his died in Bologna,* which place might have been the original
residence of the Mignoto family. With some liberty, it may be assumed
that at the time of the Valsesia plague Mignoto was an old man. He was
probably born between 1460 and 1470, and after his graduation as a
medical doctor he journeyed through Italy, visited various cities, even
the town of Mazzara in Sicily.*

His love for traveling finally brought him into trouble. He was cap¬
tured by a certain Ali ibn Yusuf (Haly filius Joseph) and was enslaved
for some time.* De Renzi mentions, without indicating the source of his
information, that Mignoto was a slave in Africa. Most probably, the
place of his slavery was the Iberian peninsula since, according to his own
statement, he escaped from prison into Spain.® Granada, the last strong¬
hold of the Moors, was recaptured only on January 2, 1492. Probably,
Mignoto’s captivity falls before this date.®

In 1524, we find him back in Italy again, in the town of Lodi, south¬
east of Milano. Here he met a holy man to whom Saint Roch appeared
in a vision, announcing the approaching epidemic of plague. The saint
also demanded that a church be erected to his honor. The church was
under construction at the time of Mignoto’s sojourn at Lodi.^

The second wave of epidemic pestilence was already raging in Italy.
It Started in August 1521 when the first cases were seen in the towns of
Noto and Syracusa in Sicily.® In 1522 the plague reached Roma, and

’ Mignotydea, f. M'’: “ letitia consumpsit, patruus etiam meus Bononiae ob filii quem
longo tempore non viderat adventum mortem cum vita coram eo statim commutavit.”

'Mignotydea, f.7^: “et vidi similiter in quadam civitate, que appellatur Mazarus,
homines qui propter immensam famem querebant et frangebant ossa antiqua et vetusta
cadaverum et comedebant medullas ipsorum.” Anthropophagy was not uncommon in the
15th and 16th century. E^rly syphilographers mention it as a possible cause of syphilis.

* Ibid., f. 6’': “ Et ego vidi, quum eram in carceribus Halii filii Joseph homines qui
comedebant olera, quae inveniebant per terram et etiam comedebant ex speciebus anabule.
i.e. ex speciebus titimali, propter fami necessitatem, quare quottidie morid)antur x vel
xii aut plures. ...”

* Ibid.: “. . . et postquam evasi cum adiutorio Dei ex illis vinculis et redii in His-
paniam vidi homines qui comedebant orobum. ...”

‘There is no Ali ibn Yusuf among the sultans of the Nasrid dynasty. There was an
Ali abu-1 Rasan who ruled from 1461 to 1485. Could he be the Haly who captured the
Italian doctor? If Mignoto were at least 20 years old when taken prisoner, his date of
birth cannot be later than 1465.

'Ibid., f. 8’': “Nam 1524 . . . virum quemdam allocuti fuimus . . . apud Civitatem
Laudensem (Lodi).”

*Cf. Guerrini, G. Notizie storiche e statistiche sulla peste. Riv. star. sc. med. not.,
1925, 16: »3-316.

186

CLAUDIUS F. MAYER

killed thousands of people.® From the South the epidemic spread towards
the North, following no fixed paths. In 1523, it was observed in Perugia,
Orvieto, Firenze, and Venezia, where several thousand persons died. In
1524, it reached the Po valley; in March of that year Milano became
afflicted.

Mignoto, no doubt, followed the old prophylactic custom, and fled frwn
the epidemic, away from large cities, to the mountainous region of North¬
ern Italy. Following the Sesia (Sessites) river, he left the pestilential
Po valley, and finally reached the little town of Varallo (Sanctum Varalli
Sepulcrum) just at the foot of Monte Rosa on the Swiss border. Here
he settled down, and became acquainted with the Draghetti and the Filip-
pineo families, also with Gaudenzio Merula, the historian, who lived in
Lavizzara (Forum Lebetiorum) close to Varallo.

Yet, he could not escape the plague. The “ queen of diseases ” called
on the Valsesia in 1527, and Mig^noto had to witness the great famine,
the desolation of villages, the confusion among peasants and noblemen
alike, and the complete disintegration of social life brought on by the
epidemic. There was no proper food; no one to take care of the dead,
and no one who knew what to do. Mignoto stood by, however, and attended
to the sick according to his best knowledge and experience.*® He himself
became sick in 1527, and to this sickness he ascribed the excruciating
intestinal pains which troubled him in his later years.** That he was then
an old man we may gather from his remarks commenting on the treat¬
ment of indigestion. He tried to cure himself by applying local heat to
his stomach, heat in its most primitive and most ingenious form: bor¬
rowing it from bodies of young adolescent girls, a very old practice. He
trusted in his age and “ residing sexual appetite ” that he would not abuse
his human thermophore. In vain! *®

During the Valsesia epidemic of 1527 he felt the need of a book to
guide the common people of his politically and morally declining Italy
in how to take care of themselves, how to prevent epidemics by healthy

* Benvenuto Cellini was in Roma at that time. He became sick in 1523, and left an
interesting account of his personal experiences and his recovery from the plague.

** Mignotydea, at end of the preface by Bartolommeo Draghetti: “. . . a morte servare
quam omnes pariter hmnines; quod ipse facis, a mortis etiam periculo eripere. Quam-
obrem perge obsecro qua instituisti via. . . • ”

Ibid., f. 3^: “ Quare non solum intestine crucior dolore ex hoc acerbissimo morbo,
. . . sed vix me a lacrimis contineo quotiens in earn cogitationem venio.”

Ibid., f. 6U: “ Ceterum (sat scio) quod tabs amplexus residentem appetentiam
excitabit.”

MIGNOTYDEA

187

living, especially how to organize the fight against pestilence, in order to
prevent the depopulation of his once beautiful country.^

He was encouraged by his learned friends, who gladly helped him in
publishing his book. He finished its writing in 1534, and submitted it
for criticism to Gaudenzio Merula.^* In September 1534 Mignoto dedi¬
cated his work to the magistrates of Valsesia, gave the manuscript to his
friend, Draghetti,^* who, with an additional dedicatory letter addressed
to Ennio Ricci,a young nobleman and apostolic protonotary in Milano,
sent it to Gotardo da Ponte,” a Milanese bookseller and printer. In Febru¬
ary 1535 the Mignotydea, “ Mignoti idea ” as the epigrammist Francesco
Filippineo called it, left the press.”

The Mignotydea is one of the earliest and rarest general monographs
on plague and epidemic diseases published in 16th century Italy. One copy
of the work is listed in the catalogue of the Paris Biblioth^ue Nationale.
Another copy was recently acquired by the Army Medical Library in
Washington. A third copy, belonging to Edward C. Streeter in 1921,
was exhibited at the Boston Public Library Fine Arts Department.”
The book was not known to Brunet or Graesse, neither to the volumin-

“The year of 1527 was very unlucky in Italian history. The Medicis were expulsed
from Firenze. Roma was sacked by Spanish and German imperialists, and Pope Clement
VII (“ Inclemente ”) was put in prison. Mignoto, an ardent patriot, could not help
lamenting over the afflictions of his cotmtry: “ Proh dolori I Ipsa diu prostrata ac ferocis-
simorum militum laniata Italia olim faustissima, nunc vcro in primum chaos ferme
reversa, a Deo hanc ob magna delicta, tribulationibus . . . ac denique pestilentiis gravibus
et egestatibus percussam credimus.” (Cf. Mygnotidea, f. 2.)

“ See Merula’s letter at the end of the Mignotydea, dated xiii. Kal. Sextil. 1534.—
Gaudenzio Merula was bom in Lavizzara, a town in the upper portion of the Val Maggia.
He was classical philologist and historian, and teacher of arts and sciences at Milano and
Torino. For his works see Argellati: Bibl. script. Medial., 1745, 2; pt. 2, 2132-4.

“ Bartolommeo Draghetti lived in Varallo. He was a close friend of Merula, and wrote
an epigram in Merula’s Terentianus Dialogus (Lavizzara, 1543). Several members of
his family were printers.

“Ennio Ricci (Ritius) was the son of Giovangelo Ricci, envoy several times of Fran¬
cesco Sforza II, Charles V, and Felipe, King of Spain. His uncle was Erasmo, questor
of Milano (1475-1575).

"(jotardo da Ponte (Ponticus) had been printer in Milano since Nov. 10, 1500. In
1510, he had his bookshop and printing office near the church of St. Satiras. Among his
publications was Bandello’s translation from Boccaccio’s Decameron (1509), the Liber
conformitatum of Bartolommeo degli Albizzi (1510), the works of Virgilius (1516).
He seems to be a relaticm of Lodovico da Ponte (Virwiio) (1467-1520), once a printer
at Reggio, and later a resident of Valsesia.

“Francesco Filippineo, local poet at Varallo, says in his epigram, at the end of the
Mignotydea, f. 102^: “ Excipite hanc igitur mortales, protinus aegri, Ydeam, ut vobis
prosit arnica salus.”

“Cf. No. 84 in the catalog of this exhibit (Boston, 1921).

188

CLAUDIUS F. MAYER

ous Argellati. De Renzi mentioned it so inaccurately that I have my
doubts whether he ever saw a copy in Italy.*** Carbonelli found a copy
listed in the sales catalogue of a bookseller of Firenze.” Owing to its
rarity the Mignotydea had never been described.

The Mignotydea copy of the Army Medical Library is a volume 8 in.
X 5yi in., bound in contemporary stamped leather, which was recently
rebacked. It passed through the hand of one known owner, a physician
called Giambattista Cacci (Catius, or Cahius?), whose very legible 16th
century notes are found on the fly-leaves. The full title, printed within
a historiated woodcut frame (see illustration) in the form of two super¬
imposed top-heavy triangles, reads as follows:

“Mignotydea De/ peste, & humanu Alteran-/tibus corpus nccesario (sic!)/
omnibus sanitate af/fectatibus utilissi/ma, quae in se/cotinet prae/cepta/me-/moratu
dig;na, multis ex Au/ctoribus excerpta, in vnu/collecta, quae ad uali-/tudine tu^m,
&/aegritudine re/mouedam/ plurimu/ codu/cut.”

The collation is: A*, 102 leaves numbered (—A*-M®N*), O®. The
foliation is often incorrect. The numbers of leaves are all Arabic, except
f. xi, xii and xiii. There are 38 lines to a full page (measured on f. 8),
and the size of the text is 165 mm. x 108 mm. There are signatures,
catchwords, occasional guide-letters, marginal notes, all printed in Roman
letters of four different types. The book is thronged with floreated, figur-
ated and historiated woodcut initial letters. At least twelve different
types of initials can be recognized. There is one floreated small type which
resembles our modern futuristic designs. Another type, in. wide, has
hollow letters, with naked children playing among beautiful flowers
against a black background. The arrangement of the contents is the
following:

f. (A^"^): titlepage;

£. (A^'') : “In Mignotydeum, Carmen” by Gaudenzio Merula, of Lavazzara;
“ Naturae Phyto squallenti emersus ab antro . . . (etc.) . . . Cuius ingenio est
ipse redempta nece.”

f. A*'-A®'': Preface of Bartolommeo Draghetti to Ennio Ricci: “ Consueverc
qui litterarum monumentis opus. . . . (ends) . . . Compararunt, ut initam de te
spem aeques ac etiam superes. Vale.”

f. A*>'-A*'': preface of Giammaria Mignoto to the wise men, consuls and judges

*** Cf. in his Storia, 1845, 3: 582. “ Giovanni Maria Mignoto di Piodi( ?) nella Valsesia,
che fu schiavo in Africa, descrisse la peste del 1525(?), e la carestia del 1532, nell’opera
Magnotidea (sic!) de Peste (1535).”

In his Bibliographia medica typographica Pedemontana, he reproduces under No.
244 die description found in the sales catalogue.

mfcnotydeadb

^tSteiSC humanu Altrtan<*
dbus corpus nccdfario
omnibus fanitarcaf
fccladbusunlifsi
ma \quxin fe
couiict pne
ccpta
tiie«

mofant dtgna, mutds fx An
dortbascxcetpcasiUi vnA
collc^sqox id oatP
tudiDccu^tiK^fiC
aegritaditi^ie
mouldam
A plutimA,

S’.-

Title-page of Giammaria Mignoto's Mignotydea (Milano, Gotardo da Ponte, Feb. 1535).

189

190

CLACDIUS F. MAYER

of Valsesia: “ Perlustranti saepenumero inihi .... (ends) Mig^otum vestrum
(ut facitis) comendatuni habete. ex Sancto Varalli Sepulchro, pridie idus Septem-
bris. 1534.”

f. l'’-98' : text “ Mignotydea de peste foeliciter incipit . . . ;

f. 99''-102'': table of contents;

f. 102'’: epipram of France.sco Filippineo (Pbylippinaeus); " Mignotydeam
(|uisquis . . . (ends) . . . prosit arnica salus”; followed by tbe colophon:
” Mediolani Excudebat Gotardus F’onticus. Mense Februario. MCCCCCXXXV.”

f. 103''-104'': corrigenda prepared by Dragbetti;

f. 104'': Letter of Gaudenzio Merula to Migneto: “ V'idi non modo . . . (ends)
Ex Forolebetiorum. xiii. Kale. Sextilib. Annoa virgineo partu MCCCCCXXXIIII.”

In its general arrangement, Mignoto’s epidemiology does not differ
much from earlier 15th century works on pestilence. As it is today, there
was also in the medical literature of the 16th century an established pat¬
tern of presenting the subject matter, which we may find already in the
Tractatus de peste of Pietro da Tossignano, who wrote after the plague
of 1398. Mignoto divides his material into 3 b<x)ks, each b<x)k into sev¬
eral parts, and each part into several chapters.'" In the first book he
enumerates the causes and signs of pestilential diseases, and explains
shortly the pathology of their cutaneous manifestations; he also mentions
why some people are more predisposed to pestilence than others. Since
he finds that by proper observations of the hygienic rules much sickness
could be avoided, he devotes the second b<K)k to personal hygiene and to
dietetics, with lists of fo(xls. and many' recommendations for healthy
habits in eating, sleeping, sexual life, etc. The third book, which is the
most important part of the Mignotydea, describes not only individual but
also public prophylactic measures against epidemics, also the duties of
the plague dcKtor, with a few words on the treatment of various infectious
diseases.

Though this material is not new, since the original purpose of the work
was to be a guide for the people to control pestilence, he deserves great
credit for the thoroughness of his writing, which is an excellent summary
of the views held by medical men generally, especially by the followers of
Galen and the Arabs. Moreover, regardless of what the author found in
his .sources of reference, he is convinced that epidemic diseases spread by

"Liber I (f. I'-f. 26^) : pt. 1 De causis pestis (11 cb.) ; pt. 2 De signis pestis (19 ch.);
pt. 3 De dubiis pestis (17 ch.).— Liber II (f. 26^-f. 64'') : De sex rebus non naturalibus
in 11 parts.— Liber III (f. 64''-f. 98'') ; pt. 1 De gemmis (17 ch.) ; pt 2 De herbis (IS
ch.) ; pt 3 De medicinis compositis (14 ch.) ; pt. 4 De phlobotomia (6 ch.) ; pt S De
loco tuendo ne morbo inbciatur (5 ch.) ; pt. 6 De cura morborum (10 ch.) ; pt 7 De
orationibus (4 ch.).

MIGNOTYDEA

191

contact; that there is a contagium which can be best controlled by organ¬
ized public efforts. Therefore, in addition to the many worthless or
superstitious remedies incorporated into his book, he advises the magis¬
trates of Valsesia to follow his plan in adopting sanitary measures against
pestilence. No doubt this portion of the work, the fifth part of the Third
Book, is based entirely on the author’s personal experiences gained during
the second 16th century Italian pandemic of plague. Being much more
than a mere bibliographical curiosity and rarity, the Mignotydea deserves
our further attention.

The first part of its First Book begins with definitions, since—as
Mig^oto says—any investigation should start with a clear knowledge of
its topic, “ according to Galenus.” There was, indeed, much confusion at
Mignoto's times about pestilence, and pestilential fevers. He recognized
the difficulties of the indifferent use of terms, and attempted to separate
special types of epidemics from the main syndrom of pestilence. According
to him, morbus pestilens, pestilentia, pestis contagiosus, contagium, lues,
and “ epydimia ” are synonymous expressions of a disease contracted
from infected, poisonous food or air. It is contagium because it infects by
touch. When many people die, the contagium is called “ pandimon.”
Since the afflicted person tends to deceive others about his illness, an
epidemic disease may be justly called “ a fallacious disease ” (morbus
fallax), or by the popular terms of “ bozula ” or “ cotes.” Its malignant
character makes the infectious disease an absolute one (morbus abso-
lutus) ; indeed, it is the queen of diseases (regina morborum).

God himself is in many ways entangled in the causation of epidemics,
which he uses as his whip to punish mankind for immoral life. The stars
and the celestial phenomena, such as the constellation of certain heavenly
bodies and the eclipse of the sun, are in direct causative relation to pesti¬
lence, as shown by the unusual astral events preceding the epidemics in
1347, 1501 and 1524. Our own sins make us an easy prey of the evil
spirits, who can do all sorts of evil, though with God’s will, and who are
able to produce diseases or to rob men of their semen and to throw it into
the wombs of bad women, where it induces conception of their evil off¬
springs. Maybe Martin Luther was also one produced by such a demonic
power (f. 4'').

The stars, by their penetrating rays, act upon the atmosphere, and may
corrupt it. The air also becomes noxious over stagnant waters, marshes,
cloacae, or in the proximity of large military camps. Smoke will corrupt
the air; so do fetid vapors. The corrupt air stinks, and he who lives in it

192

CLAUDIUS F. MAYER

cannot avoid pestilence. It penetrates his body; if it reaches the heart,
putrefaction of the blood is caused, and heat is liberated from the heart,
which, spreading through the entire body, causes the pestilential fever.
The wind often brings the noxious air even to remote valleys; thus, it is
a vector of pestilence.

Beside corrupting the air by their bad vapors, putrid and fetid waters
may also cause epidemics when'used for drinking. Mignoto recognized
that water-borne epidemics differ from other pestilential diseases, and
they are probably worse than the other types. The liver is damaged by
them, the hepatic pathways are obstructed, hydrops is caused; the spleen,
the kidneys, and the bladder are also affected.** It is therefore the best to
drink only spring water, since even the aqueducts will deteriorate the
drinking water by adding to it too much earthy substance (“ terrestri-
tates ”). Such water is not entirely harmless, as seen in certain districts
of Italy where goiter (“turgida guttura”) is caused by drinking it
(f. 6'^). The ground itself is sometimes putrid, either on its surface or
below, due to putrefaction of dead bodies or to venomous animals. Thus,
an entire town is made easily a place of pestilence, especially when the
cemeteries are within the town, the feces are not properly disposed of by
sewage, or if certain occupations are tolerated to produce fetid vapors as
in hanging up raw hides, or putting hemp in water for softening. A multi¬
tude of frogs is also dangerous to the health of the town.

Epidemics may originate from eating improper food when there is
scarcity in the food supply. Spoiled grain or vegetables or putrid meat
is often eaten at a time of famine. He himself saw, while in slavery, how
every day ten or twelve persons died from eating such unfit food as
“ anabula ” (?). In Spain he saw hungry people eating bitter vetch
(Orobus), and getting stomach-ache. Others consumed “attrahala"
and the roots of “ ruf,” and died.** In Mazzara City he witnessed such a

"Mignotydca, f. 5^: “adhuc peius faciunt, quia sunt causa destructionis hepatis et
opilationis suarum viarum, et procreant species hydropisis omnes secundum prepara-
tionem recipientis et inducunt in splene opilationem et in renibus et vesica, et generaliter
dico quod haec epidimia, quae fit ex corruptione ac putredine malae aquae, omnibus aliis
epidemiis deterior existit.”

** Orobus (Leguminosae) was in great esteem in the 19th century among the High¬
landers of Scotland for the Uibercles of the root; they dry and chew them in general to
give a better relish to their liquor. By the use of them they are enabled to repel hunger
and thirst for a long time. In Holland Orobus tubers were eaten as chestnuts (Loudon).

“Attrahala ” is a corrupted form of at-tarhala, which means either Scrophularia or
Fumaria. Scrophularia or figwort was used for treatment of scrophulous tumors through¬
out the Middle Ages. The garrison at Rochelle was reduced to the necessity of supporting

MIGNOTYDEA

193

famine that people were forced to eat the bone marrow from human cada-
vcra, from which they died suddenly. There are many varieties of corrupt
or poisonous food; hence, the disease caused by them will appear in various
forms. With pity he remembers the epidemic plague of 1527 and the
accompanying famine in his Valsesia where more than eighty of his good
neighbors were without food, searched for herbs, picked up rotten apples
or the bones thrown to the dogs, and chewed rotten turnips; many of
them died. Not only famine, but plenty and the excess in eating, in
general any abuse of the “ res non naturales,” food and drink, sleep and
vigil, work and rest, hunger and satiety, emotions and sexual life— they
all may predispose to epidemic diseases.

Summarizing Mignoto’s etiological views, we find that he was on the
right track of truth. He considered man a part of the large world, whose
existence depends—not to mention God, the constant factor in every¬
thing—chiefly upon his environment: the air which surrounds him, and
the weather and its changes; the water and the ground; the food; also
upon his habits in eating, drinking, working, resting, sleeping, affections
and sex life. There is a normal balance between man and his Universe;
when one or the other comes out of gear, epidemic diseases will result.
These may descend from the sky with the air’s vapors, and are carried on
by wind or weather. They may come from food and drink, or they may
develop by themselves in neglected, unsanitary towns. Since there are
many sources of contagium, there are also many varieties of pestilential
fevers.*'*

After exposing the remote causes, direct sources, and predisposing
factors of infection, the author’s next step is to explain the methods by

life upon the roots of this plant at the siege by Cardinal Richelieu in 1628. Fumaria was
used as an antiscorbutic and laxative.

“Ruf” is for the Arab luf, which is the Arum dracunculus, or the dracontion of
Dioscorides.

" It has to be recalled that the bacterial cause of infection was recognized and accepted
only in the last half of the 19th century. As late as 1844, Doctor Elia Rossi, medical
officer in the service of His Highness, the Viceroy of Egypt, still considered the plague
and other epidemics as physical modifications of the social status “ una modalita fisica
dello stato sociale” (Cf. his Brano di una cronologia, 1844, p. 74). He assumed that
epidemics have complex causes inherent partly in certain social conditions and partly in
certain relations of our physical ego with the environment “ L’uomo vive in rapporto
con cio che lo circonda; influenza, ed e influenzato” (ibid., p. vi). No doubt there are
concurrent infective causes: some transient as war or other extraordinary calamities,
some permanent Among the latter he mentions the geological factor, the malignant
exhalations, and other cosmic-telluric factors (ibid., p. 15). I cannot find great differ¬
ence between the views of Mignoto in 1535 and of Rossi in 1844.

194

CLAUDIUS F. MAYER

which these causes and factors could be recognized. This explanatiwi
forms the second part of the First Book of the Mig^otydea. We read of
' premonitory signs of God’s ire, signs in the stars, in the air and weather,
from which a coming pestilence can be forecast. Frequently, an increase
in crimes and the general immorality is a sure sign, a remote sign, of
future epidemic diseases,** since immoral life is an indication that people
have forgotten God; he first tries to remind the people of his existence by
extraordinary phenomena in Nature, by miracles, visions, or even by
prophets. People should then expiate him by prayer, by building churches,
or by penitent processions such as the one in 13%.** Thus, pestilence
could be still averted. Astrologists are also able to forecast future plagues
by observing the conjunction of the stars; experts may even prevent dis¬
eases of individuals. Other premonitory signs are produced by evil spirits
in the depth of the earth or on the sky where the demons can produce
clouds in the form of dangerous animals, or fires, etc. The evil one often
takes on the human form, and he may be the unknown hobo or trollop seen
lurking in the dark. The appearance of such people in a village was often
followed by epidemics.

There are many other signs in the air and in the weather which indi¬
cate a noxious, infective character of the atmosphere; such are the noc¬
turnal radiations, the falling stars (meteors), or any unnatural or sudden
change in Nature, in weather or wind, unnatural seasons as cold springs
or hot winters, unusual early blooming of flowers, etc. The noxious
character of the air is much sooner recognized by the sensitive birds and
the reptiles than by man. Let us, therefore, watch what these animals are
doing. Subterranean animals may feel the oncoming danger of under¬
ground corruption. When they crawl out of their caves or leave their
natural habitat it is certain that an epidemic is in the offing. There may
be also sudden increase in worms and flies, or the birds may fly in flocks
away to the mountains.

These are, according to Mignoto, the signs of “ pestis,” that is of a
general corruption of Nature and human environment. In such an
environment a person easily will contract infection, or may develop a type

•• Mignotydea, f. 9*: “ Quum videritis ilium sacrilegum adultenim, ilium ad neces
hominum, ilium tabulanun fidem mutare, ilium venena miscere, ilium quiescentium securas
animas et Icthei oblivione purgatas nephariis carminibus excitare, ilium vides puerorum
complexibus inhercntem, denique quum videris cuncta scelera dempto fine increscere,
expergescimini. ...”

Ibid., f. 9*: Mignoto here refers to the procession of the Albati or Bianchi, a psychic
epidemic that started in 1399 in Marseille and ended in Italy.

MIGNOTYDEA

195

of “ pestilential fever.” The author distinguishes “ infection,” “ pesti¬
lential fever,” smallpox and measles, and various other cutaneous swell¬
ings which he calls apostema, according to the pathological nomenclature

his century. How can we recognize “ infection ” ? An expert’s eye
can see it on the very first day by the following signs, some of which or
all may be present in the infected: loss of appetite, sleepiness, chills, frontal
headache, stiff neck so that the sick cannot look up at the sky, crossed or
sunken eyes, shyness of daylight (photophobia), difference in the size of
the eyes (pupils?), red eyes, green or black face, paleness, laziness and
heaviness of the body so that the sick cannot walk or ride on horseback
or cannot do his daily work. On the following days, an apostema may
grow in the armpit or around the genitals or behind the ears. The infected
man vomits, and his bowels are loose. His tongue feels heavy, and is
coated white or black; there may be even a pustula on it. His lips are
Hvid, and his nares distorted. He may be unconscious, and his skin may
be covered by many other apostemata all over the body. This description
seems to fit the general course of many exanthematous infections, includ¬
ing the bubonic plague. The symptoms are not features of one disease.
Yet, there is an excuse for Mignoto: acute infectious diseases have a
general resemblance both in their symptoms and in their clinical course.

Among the sig;ns of “ pestilential fever,” Mignoto mentions fever as the
first characteristic. Other symptoms mentioned are again rather general:
anxiety and restlessness, dyspnea, sometimes rapid and weak pulse so that
the systole is larger than the diastole, thirst, swollen tongue, sudden vomit¬
ing, syncope, epigastralgia, loss of appetite, bitter taste in the mouth, cold
extremities, deliria and convulsions, or sleeplessness, black fetid and foamy
feces, enlargement of spleen, swollen abdomen, diarrhea, yellow eyes and
face. In another chapter, he gives a brief account of smallpox and morbilli,
which he also calls “blacellae.” These two diseases may affect anyone
regardless of age. The difference between variolae (smallpox) and
morbilli is chiefly in the size of the pustule. Both diseases often precede
the plague.

In several chapters, the author discusses the differences between
anthrax, carbuncle, pruna, bubo, which all are types of apostema. Pruna
or carbo is a small apostema the appearance of which is preceded by itching.
Its form is a vesicle, which may be of various colors. Carbuncle is first a
pruna, but it enlarges and has an inflammatory area; it is a pustula which
will leave a scar. Anthrax is a malignant carbuncle; it exulcerates, pene¬
trates deep into the body by means of its root; it may cause an inflamma-

196

CLAUDIUS F. MAYER

tory phlegmonous swelling. Bubo or glandula, called also patrachia or
petrachia, or althohoin by the Arabs, is an apostema which develops in
the armpit, on the groin or behind the ears—all these sites being in direct
vascular relation with vital parts of the body: the heart, the liver and the
brain. There are four varieties of bubo according to the putrid matter
which collects in them; if this matter is blood, the apostema is called bubo
phlegmones; if it is bile, it is called “ phlegmon horsipilides,” or “ hersipi-
lades flegmonides ”; if it is phlegm, its name is “ phlegmcme undimiale ”
or “ undimia phlegmonides ”; if it is black bile, it is “ flegmon sephirodes.”

Human beings, as the author says, are different in their body constitu¬
tion. They will, therefore, react differently to the same infection. Some
succumb easily, while others are entirely immune (“ insuperabiles ac
impassibiles omnino”; f. 17^). There are certain factors which almost
certainly prepare one for infection. They are: 1) lack of moderation, 2)
general relaxation and dilatation of the pores of the body so that pesti¬
lential air can easily enter into the body, 3) any disease of the stomach
and the liver since it causes malnutrition, 4) famine, poverty, and warfare
(social factors). The seasonal appearance of epidemics in the late sum¬
mer or early fall is explained by the effect of summer heat which decreases
the general resistance of the body. Animals are also affected by various
diseases like man; they are also exposed to the noxious effects of corrupt
air. The fish, though it has some diseases, is mostly immune to pestilence.

Any doubts? Yes, there are some which the author finds important to
answer in the third part of the First Book of his work. Here he mentiwis
that certain villages may be spared by a pandemic disease because they are
better protected by their stars, weather and climate. The death of entire
families in pestilence is explained by the fact that members of the same
family have the same environment, eat the same food, their bodies are
built with the same constitution, and they are equally predisposed
(exposed) to the infection. The close proximity of family members also
favors the propagation of contagium by touch.

Man is fragile by nature, exposed to many diseases and evils. It is
therefore necessary for everyone to be cautious and to protect himself
from diseases. The best protection is the proper regulation of life. The
requisites of normal life are contained in the Second Book of Mignotydea
essentially a code of hygienic regime (Regimen sanitatis). He goes
through a long list of foods, including bread, meat, eggs, fish, vegetables,
roots, seeds and grains, fruits, etc. Foods should be individually selected
according to the constitution of the human body. There is a well-tempered
ideal bodily constitution (corpus temperatum), for which a temperate

MIGNOTYDEA

197

diet should be selected (well-balanced diet). But, at a time of epidemics,
everyone should eat the ideal food. He gives many rules for the time and
order of meals, and does not forget even the cook, who should be good by
all means, and not too voracious. It is enough for an adult to eat only once
a day, or every 16 hours so that the material of the previous meal is
given sufficient time for digestion.

In healthy life, the quality of the air is as important as the quality of
food. Good air is hardly found in cities, or on lowlands. Bad air can be
corrected by odoriferous substances. Exercise is also important such as
playing ball, walking or mountain climbing, gardening. The author also
recommends equestrial games, and sport such as running, jumping,
archery, hunting. The sport and other exercise should be appropriately
selected according to the person’s age, complexion, and habits. Rest is as
necessary for the health as exercise. Sleep is one form of resting, and even
an afternoon siesta is proper if it is one’s regular habit. Those who have
a weak stomach should lie on it, though digestion is better if one lies on
his right side. In case of indigestion, which is due to lack of natural heat
in the stomach, one should hug a feather pillow, or keep his hand over his
stomach; or it is still better to lie naked with a beautiful 14-18-year old
blonde.** This should be done, however, without any sexual intercourse.
Further health rules follow on coitus, which is generally not recommended
at times of pestilence.

As further care of the body Mignoto recommends that in the morning

“This seems to be an advice originally given by Galenus in his Tegni, Lib. 2. The
custom was fairly common and Emperor Sigismund used to have his daily treatment
The recommendation may be found in earlier pest regimes as itt Steinhdwel’s Biichlein
der Ordnung (Ulm, 1473). Mignoto refers also to Aristoteles (Ad Alexandrum Magnum
Regimen sanitatis), and to Guainerio’s work. The length by which Mignoto describes
the qualities of the remedy is remarkable (cf. Mignotydea, f. 61'):

“Si quis bene non concoxit experrectus mane quiescere in strato debet et redormire
et ut melior celebretur concoctio, cervical plumeum in amplexu continue teneat. Manus
quoque diu super stomachum retenta digestionem valde confortat. Verum longe meliorem
confortationem prestabit puella calida, speciosa et bene complexionata (ut scribit Aris¬
toteles ad Alexandrum Magnum) quae sit anno 14 usque ad decimum octavum inclusive
ac succi plenum, aureis cum capillis, oculi clari sintillantes; arcuatis cum superciliis,
pilis paucis, contextis subtilibus, genae rosaceae, labia corallina, eburnei dentes, propor-
tionabiliter tarn in situ quam in magnitudine in ore mellifluo collocentur. Anhelitus
suavis et dulcis, amplum et candidum pectus, cuius in lateribus duae instar pomorum
Sint insitae mamillae, denique omnes totius corporis partes tarn occultae quam manifestae
sint bene proportionatae. Quanto autem formosior fuerit puella, tanto melio(!) cele-
brabitur digestio ex caloris ipsius reflexione. si nuda prope imbecillem stomachus saepe
morabitur. Hoc nullum excellentius pro stomach! confortatione medicamen invenimus.
Non tamen omnibus fas est hoc uti. Lautorum haec medella est. Ceterum (Sat scio) quod
talis amplexus residentem appetentiam excitabit.”

198

CLAUDIUS F. MAYER

one should stretch his arms, neck and legs, and rub clean the armpits, the
groin, especially after sexual intercourse, and behind the ear (“ loca
emunctoria ”). The scalp should be dried with a hot towel, and the hair
combed upwards in order to remove dandruff. The feet, head, and beard
should be washed 2-3 times a week. The mouth should be cleaned with
much water or with special lotions, also the hand and face, especially in
the summer time. The teeth should be rubbed with leaves of Citrulus in
summer, and with lemon peels in winter. It is also not a worthless (“ non
inutile ”) measure to wipe oneself clean after defecation. He again recom¬
mends gymnastics and physical exercise, with an allusion to the healthy
life of country peasants. Normal health also requires a prc^rly balanced
mind. One should avoid excessive joy or extreme anger, sadness, fear
and envy. The best is to keep smiling and not to be scared of epidemics.
Fear of disease (nosophobia) itself prepares the body to infection. One
should look at beautiful things, rings and jewelry, beautiful faces and
beautiful movements. At times of pestilence, one should engage female
singers and dancers; music and dance will help to keep the mind in balance.

The Third Book of the Mignotydea contains prophylactic advice, and
measures for the control and treatment of epidemics. There is, of course,
nothing better than to leave the place of pestilence, to go away to a remote
place of temperate climate and to stay there for many months. High and
windy sites are preferable, where one should select a house which can be
well ventilated. There, one should take life easy, and, by all means, one
should not come in touch with the sick. Many people cannot or will not
leave the plague-stricken town; for them the author’s advice is to try out
some of the preservatives, the magic gems he lists, the herbs or compound
theriacs and other prophylactic preparations. <

Herbs are especially good for poor people who cannot afford to wear
golden rings with diamonds, agates, sapphire, smaragd, or other beautiful
precious stones. The common sorrel (Acetosa) will do as well, or birth-
wort (Aristologia), garlic, onion, dittany (Dictamnus), elecampane
(Inula), St. John’s wort (Hypericon), radish (Raphanus), devil’s bit
(Scabiosa), or septfoil (Tormentilla). One of the theriacs prescribed
contains the flesh of snakes. The herbs and compound medicaments can
be made in the pleasant forms of electuaries, confections, powders, pills
and tablets. One can also prepare little bags with certain herbs to wear
over the heart. For an emergency clearing of bad air, various good smell¬
ing substances can be composed in the form of apples; one should carry
such apples in hand and smell them time after time. The air of houses
can be improved by suffumigations, and large fires.

MIGNOTYDEA

199

Another good preservative is a good blood-letting. The blood is bad
at a time of pestilence, and it needs evacuation. If other body fluids are
suspected also to be corrupt, additional evacuation is necessary by laxative
drugs. There are certain compositions, juleps and waters which help the
body in digesting the cause of pestilence. These compositions should be
used before evacuation by blood-letting or by laxatives.

The most important for the control of pestilence is, however, to clean
the cities, and to remove the cause of the epidemic, which is fetor, filth, and
putrefaction. In the fifth part of the Third Book the author’s recommenda¬
tions sound very modern, and he deserves all the merit of a wise man and
good organizer, when he urges the establishment of boards of health, of
quarantines and plague hospitals, proper sewage, control and rationing of
food supply at times of famine, control of pharmacists, regulation of vaga¬
bonds, and general sanitation of towns.

For a proper appreciation of Mignoto’s “ idea ” of plague control, it
should be recalled from the sanitary history of Italy that, though sanitary
regulations were occasionally adopted by individual towns, these munici¬
pal attempts to control pestilence are reported only from the second half
of the 15th century. On July 5, 1477, Leonello d’Este published his edict
prohibiting entrance to anyone who came from a place of epidemic disease.
Certain rules were also promulgated in Padova in 1436 for disinfection
of houses and furniture, for dealing with suspected persons, for electing
guards of health and building hospitals. The earliest quarantine hospital
was erected in Venezia in 1422 or 1423. Other large cities followed this
example: Pisa built a plague hospital in 1464, and Genova in 1467. There
has been one in Firenze since 1479, and one in Milano since 1489. The
first permanent board of health, however, was not organized until 1485 in
Venezia, though this city had a private plague ambulance service already
in 1415. Regulations against plague were not available in Roma until
1522.

No doubt Mignoto has been influenced by what he saw and heard of
these scattered efforts, and he used his knowledge of the sanitary regula¬
tions in other Italian cities for the salvation of his Valsesia during the
1527 epidemic. The fact that he dedicated his Mignotydea to the consuls
and judges of the Sesia valley proves that his primary intention in writ¬
ing was to give them a code of sanitation, which apparently was not at
hand anywhere in Italy, at least not in a printed form.

It is the duty of those, says Mignoto, who are in charge of the town
to remove all rottenness and smell; if the cause is removed the effect, the
epidemic will be also removed. It is namely the rottenness and filth which

200

CLAUDIUS F. MAYER

destroys life. The prefects of the city shall order, therefore, that no
impurity be thrown into the public aqueduct. Women should not use the
public fountain for laundering, or the servants for bathing domestic ani¬
mals ; neither should pigs be allowed to use it. No one should use it for
washing himself or bathing. Sometimes the bad water infects the town.
All places and streets should be kept clean, and sewers should be installed,
otherwise a city will be always exposed to epidemics. It is also necessary
to clean out the sewage, but not in the summer; it should be washed out
on some winter night. Scattered feces frequently have caused epidemic
disease (“ex colluvie enim privata tabes haec pestifera nonnunquam
generatur”). The cadavers have to be buried, but only in cemeteries
located outside the city.

Everything that smells bad or is pungently fetid is apt to cause pesti¬
lence. Therefore, the prefect of the town or the judge, deputied for this
duty, has to see to it that foul smelling meat or rotten fish, foul eggs or
similar other things are not sold on the market. These will harm the
blood as well as the spirit of the people. They cause laxation of the
stomach, which again will lead to pestilence and various other diseases.
Also, the prefect has to supervise what the pharmacist puts on sale; many
may die from bad drugs. Dishonest pharmacists should be very severely
punished. It should be also ordered that a pharmacist should not sell
medicaments without a physician’s prescription.

Since immoderate sexual intercourse is one of the causes of pestilence,
the bad men and all those who defile chastity, together with the owners
of whore houses should be expelled from the town. If there is an immi¬
nent epidemic, even the healthy beggars should be driven out of the town
because they are the ones who by going from house to house are the
carriers of the epidemic.**

Since poverty and famine predispose to epidemics, the decurios or the
prefect of the town should take care that the food supply of the town is
properly rationed; they should import food from the neighboring countries
basing their estimate upon a census of the population. The rich should
sell the surplus food, even below regular prices; if they are not willing,
the poor people be allowed to steal or to rob whatever food they need.

When there is an epidemic, guards should be stationed at the entrances
of the town, who, under the penalty of 100 silver marks, should not let
anyone pass without proper passport (“ litterae dimissoriae’’ or “ bole-
tinus ”). They should take care that no one enters under false name or

*• A similar rule was adopted by Niimberg in 1494.

MIGNOTYDEA

201

under false pretenses. The visitor should swear that he did not sojourn
in any plague-stricken town within the last 40 days. No one should be
allowed to leave the town without the permission of the deputies or without
a bulletin, signed by the official deputy and sealed with the public seal of
the town.

Next, Mignoto describes the proper behavior and duties of a plague
doctor. The doctor should get rid of his nosophobia; he should be of
joyful mind, and by no means of the pitying type or one who is afraid of
dying. Fear has to be cut out (“ Timor ergo resecandus est ”). Absolute
honesty, decency, devotion to the sick should be his general qualifications.
He should not be talkative, yet he should talk enough to put the patient
at ease, and he should do everything rather to-day than to-morrow. Even
though he will not cure many, he should not be discouraged; after all he
has not the power of a prophet of God. Mignoto regrets that many physi¬
cians refuse to deal with epidemics, and only the irregular empiricus is
left, who works only for his material gain.

For his protection, the doctor should purgate himself with drugs, phle¬
botomy, cauterization of the legs and arms. He has to use smelling prepa¬
rations, and preservatives ever so often. Daily changes of clothes, and
taking a new fumigated dress every time when he goes visiting the sick,
is a good precaution. Just before his visit he should eat hot bread
moistened with wine. During the visit, he should chew a gum containing
the peel of lemon, zedoaria, dyttany, tormentilla, camphor, clover, peonia
mixed with acacia and tragacanthe gums and wax.

A sick person, when discovered, should be immediately removed from
the town; any putrid food in his house should be confiscated, and any
sick animal of his killed. The deputies should take care that places be
established outside the city for the detention of the sick. These places
should be encircled by wall or by deep ditch, and no one should be allowed
to visit the sick. Noblemen could be quarantined in better hospices or
taverns. The health guards should transfer them to country places or to
small country houses. The lepers should be thrown out of town because
they make a very bad impression on the mind of the citizens.

After putting the infected in detention, his house should be purged,
together with his furniture. Anything that cannot be washed has to be
burned. Furs of great value should be fumigated for 15 days with smell¬
ing herbs. Bed feathers have to be removed from the pillows, put in sacks,
and buried in the ground for 3 days; then, they must be exposed to the
sunrays for 4 days to dry, sprinkled with strong vinegar, and fumigated.
Other methods are described for treating silk clothes, linen, towels, shirts.

202 CLAUDIUS F. MAYER

tables, and the air of the house, by fumigation or by washing with soap
and water.

Not much can be said on the treatment of pestilential fever. It includes
a) general nursing, b) evacuation of the “ materia peccans ” by enemata,
laxatives and phlebotomy, c) supporting the heart’s action by tonics,
and d) symptomatic treatment. Syncope is treated by rubbing the skin,
immersion of the foot and hand into hot water, and other stimulation of
the body. Dyspnea is helped by rubbing the chest with oils, anointment
of the neck, wet applications, and cold applied over the stomach. Coma
(“ sopor ”) is best treated by ligation of the extremities, and causing pain.
A special chapter describes the cure of smallpox and morbilli. After the
appearance of the pox, the pustules should be opened with golden needles.
The eyes, nose, throat and mouth should be especially protected. Various
composite medicaments may be applied for the removal of ugly scars.
Bubo, carbuncle, anthrax and pruna indicates phlebotomy; but when the
apostema is ripe, which can be quickened by the application of plasters,
it should not be touched, especially when it opens. The content of the
apostema is, namely, highly contagious, and very often the physicians
become infected.

Though it would be irrational if a physician would treat diseases by
prayers, one should not neglect to pray to God and to the saints. The last
chapter of the Mignotydea contains prayers to various saints as the last
resorts of help. There is one even to the mystic symbol of Thau. St.
Sebastian and St. Roch occur in several supplications and hymns.*®

All this is written in a simple style. Mignoto is well versed in Latin
classics, in the writings of poets and physicians. His medical education
reflects his reverence of Galen and of the medieval school of Arabic medi¬
cine. Once or many times, he quotes about seventy authors of whom
thirty-two are physicians, fourteen of them Arabs. Only five 15th century

*• On f.97»:

“Ave Roche sanctissime,

Nobili natus sanguine.

Crucis signaris stigmata,

Sinistro tuo latere.

Roche peregre profectus,

Pestifere curans tactus,

Egros sanans mirihce
Tangendo salutifere.

Vale Roche angel ice,

Vocis citatus famine,

Qui potens es deifice,

A cunctis pestem pellere.”

MIGNOTYDEA

203

authors are referred to. In many cases the reference includes also the
title of the author’s work. A list of the number of references to each
author shows best the chief sources of the Mignotydea: Galen references,
106 from 20 of his works; Ibn Sina, 73 from 4 works; Aristoteles, 21
from 10 works; Ibn Roshd, 19 from 2 works; Hippocrates, 19 from 4
works; Ali ibn Abbas, 16; Dioscorides, 16; Isaq the Jew, 11; Pietro
d’Abano, 9; Plinius, 9; Albertus Magnus, 8; Ibn Zohr, 7; Macer Floridus,
7; Celsus, 6; Mesue, 6; Mathaeus Sylvaticus, 4. One or two references
are made to Abul Qasim, Arnold of Villanova, Dino di Garbo, Gentile da
Foligno, Marsilio Ficino, Guainerio, John Gaddesden, Maimonides and
Serapion.

Before the publication of the Mignotydea there were various treatises
written on pestilence in the 15th and 16th century. In Italy the first
plague treatise was written in the second half of the 14th century, about
1360, by Mainero. Among the 15th century pest incunabula Klebs found
145 editions of 46 works. Of these, only 33 were published in Italy, and
only a few are larger monographs. They are the works of Pietro da Tos-
signano (Venezia, 1475), Giacomo Soldi (Bologna, 1478), Geronimo di
Manfredi (Bologna, 1478), Marsilio Ficino (Firenze, 1481), Antonio
Guainerio (Venezia, 1487), and Pietro Pintor (Roma, 1499). Many
others remained manuscripts, as the II Libro Della Pestilenza of Giovanni
de Alberti of Capodistria (edited in 1924 by Arturo Castiglioni from a
manuscript in Wien; Bologna, 1924). All of these earlier pest treatises
show the influence of Galen and Ibn Sina, and are constructed on the
same plan.

In the 16th century Italian medical literature, pestilence and pestilential
fevers became the most important topic of discussion. Each wave of plague
epidemic produced an increase in this literature. The first pandemic
resulted in only three small plague pamphlets written by Pietro Bairo
(1507), Gabriele Preciato (1504), and Gaspare Torrella (1504). The
second pandemic produced three general epidemiological works written by
physicians. All of them are book rarities, and the Mignotydea is the
largest and the most exhaustive among them.

Mignoto’s views on the importance of quarantine, on the sanitation of
towns, on the hospitalization of the sick, and on disinfection of what the
sick might have touched show clearly that he is one of the early promoters
of the doctrine on contagium. He may talk of the influence of stars and
the evil deeds of demons, but by his actions he reveals his firm conviction
that epidemics are transmitted and spread by contact with the infective
matter, the contagium: a view which eleven years later (1546) was widely

204

CLAUDIUS F. MAYER

promulgated by Fracastoro, whose work—perhaps better advertised, and
published in a larger number of copies than the Mignotydea—became the
starting point of the long fight between contagionists and anticontagion*
ists carried on throughout the 16th and 17th century epidemiological
literature.

REFERENCES

Argellati, Filippo. Bibliotheca scriptorum Mediolanensium. 4 v. Milano, 174b.
Boston Public Library. Exhibit of early medical texts illustrating practice in fevers,
plague, etc. Boston, 1921.

Carbonelli, G. Bibliographia medica typographica Pedemontana. Roma, 1914.
Corsini, A. La moria” del 1464 in Toscana e I’istitusione dei primi lazzaretti tn
Firenze ed in Pisa. Firenze, 1911.

Crawfurd, R. Plague and pestilence in literature and art. Oxford, 1914.

De Renzi, S. Storia della medicina in Italia. 5 v. Napoli, 1845.

Guerrini, G. Notizie storiche e statistiche sulla peste. In Riv. stor. sc. med. not.,
1925, 16 : 293*316.

Haeser, H. Geschichte der epidemischen Krankheiten. Jena, 1865.

-. Bibliotheca epidemiographica. 2. ed. Greifswald, 1862.

Klebs, A. C. Die ersten gedruckten Pestschriften. Miinchen, 1926.

Ozanam, J. A. F. Histoire medicale, etc. 2. ed. 4v. Lyon, 1835.

Rossi, E. Brano di una cronologia storico-critica che forma parte dell’istoria della
peste. Livorno, 1844.

Simonini, R. La peste negli Stati Estensi dal 1000 al 1400. In Riv. stor. sc. med.
not., 1924, 15:1-28.

Thierfelder, J. T. Additamenta ad H. Haeseri Bibliothecam epidemiographicam.
Misenae, 1843.

LA HISTORIA Y LA FILOSOFIA DE LA CIENCIA

ALDO MIELI

Cuando, a mediados de 1939, la Universidad Nacional del Litoral me
llamo para fundar y dirigir en la ciudad de Santa Fe (Republica Argen¬
tina) el Institute de historia y lilosofia de la ciencia, me di cuenta inme-
diatamente de las dificultades que, de una manera inevitable, debian surgir
en esta tarea. Fuera de la existencia de unos pocos investigadores en la
historia de la ciencia, de los cuales algunos verdaderamente sobresalientes,
no habia en toda America latina una organizacion totalmente dedicada a
esta rama del saber, ni existia en ella un principio de trabajo sistematico
y exhaustive en el vasto campo concerniente a la evolucion historica del
conjunto de todas las disciplinas cientiheas, incluyendo sus aplicaciones,
come la tecnica fisica y quimica, la medicina y la agricultura. Se trataba
entonces, no solo de reunir suficientes materiales para el estudio y tomar
todas las disposiciones necesarias para poderlos utilizar con provecho,
sino tambien de preparar el ambiente psiquico y moral para el adecuado
desarrollo de una actividad suficientemente intensa.

Desgraciadamente con mi llegada, y en el mismo viaje hacia America,
se inicio para mi tma enfermedad que con altibajos obstaculizo mi trabajo
durante tres ahos aproximadamente. Creo que si no hubiera tenido el
apoyo y la labor constante de mi colega Jose Babini, que, en complete
acuerdo conmigo, suplio a mis forzadas ausencias, no estariamos todavia
en el punto al cual hemos llegado. Despues de casi dos anos de mi llegada
pude finalmente obtener un auxiliar, y es con la asistencia de este, ademas
de la ininterrumpida de Babini, y con mi salud recobrada en forma bas-
tante normal y que me permitio desplegar un trabajo intenso, que el
Institute ha podido avanzar de una manera bastante satisfactoria hacia
la forma por mi imaginada. Agreguese, que otro impedimento para un
mayor desarrollo, es la gran limitacion de su presupuesto, a lo que deben
agregarse las dificultades en obtener, durante este periodo de guerra, fibres
y revistas del extranjero, ya como canje o a titulo de servicio de prensa
ya por adquisicion directa.

Con el aporte de mi periodico, Archeion, que funde en Roma en 1919
y que he dirigido sin interrupcion hasta hoy, el Institute pudo inmediata-
mente poseer un organo oficial, hecho este de primordial importancia.
Con sacrificios de mi parte, con el auxilio de un numero bastante relevante
de suscriptores, y con subsidies de gobiernos, sociedades, y especialmente

205

206

ALDO MIELI

de la Academia internacional de historia de las ciencias, he podido publicar
Archeion hasta 1939. Pero al estallar la segunda guerra mundial con la
consiguiente perdida automatica de la mayor parte de los suscriptores,
que eran de Europa, me habria sido imposible continuar con la publica-
cion, si la Universidad Nacional del Litoral no hubiera incluido Archeion
entre sus publicaciones oficiales, contribuyendo a sufragar la mayor parte
de los gastos.

Asegurada la publicacion del periddico oficial, mi tarea mas urgente
fue la de inventariar los libros del Instituto y confeccionar su catalogo.
Este asunto no era facil, pues no queria hacer una simple liste alfabetica
de los libros, de los periddicos y de los folletos existentes, sino compilar
hchas completas, que pudiesen tambien servir de adecuadas indicaciones
bibliograhcas. La preparacidn del catalogo fue una de las tareas princi-
pales del auxiliar Ricardo Resta, desde el dia en que pertenecid al Instituto.
El catalogo, en lo que se refiere a los libros, esta en gran parte terminado.

Claro es que no se puede organizar un trabajo cientifico, si no se pre-
paran previamente todos los instrumentos necesarios. Creemos que uno
de estos, quizas el mas importante, es un Repertorio que indique con pre-
cisidn y con la mayor amplitud lo que se ha hecho en todos los temas de
las distintas disciplinas y acerca de la vida y de la obra de los diferentes
sabios: los grandes, los medianos, y hasta los menores. Un repertorio de
esta naturaleza es una obra colosal que, en su primera etapa, requiere la
compilacidn de no menos de 100.000 fichas, y que aun no existe en nin-
guna parte, con la excepcidn, quiza, de la ordenacidn, en fichas, de la
bibliografia metddica publicada por George Sarton, si es que este sobre-
saliente historiador de la ciencia, la ha puesto en ejecucidn. A la confeccidn
del repertorio, nos hemos aplicado, Babini y yo, y esperamos conseguir
pronto otros colaboradores. Pero, no siendo posible crear un conjunto tal
en toda su complejitad, hemos empezado a trabajar sobre los materiales
que tenemos en el Instituto, de manera que las fichas que estamos pre-
parando en este primer tiempo, constituyen tambien un catalogo metddico
de las existencias del Instituto. Quiero observar que no se trata unica-
mente de indicaciones de libros, sino tambien de articulos de periddicos y
de folletos, y que muchas veces hemos agregado explicaciones y comen-
tarios. No hemos tampoco dejado de senalar con fichas de color especial
los documentos iconograficos y las reproducciones de autdgrafos. Hasta
el momento hemos llegado a preparar unas 12.000 fichas.

La biblioteca que poseemos, al catalogo ordinario y el repertorio, con¬
stituyen un conjunto que nos permite ya de trabajar con bastante exito
en el campo de la historia de la ciencia, sobre los temas mas dispares;

LA HISTORIA Y LA FILOSOPfA DE LA CIENCIA

207

al mismo tiempo hemos podido ser utiles a varies investigadores que han
acudido al Institute y permitir a numereses estudiantes preparar algunes
trabajes prescriptes per la Facultad de quimica industrial y agricela.

Agreguemes que nuestra familia va aumentande. El sener Marie Bunge
ha empezade a concurrir regularmente al Institute desde Buenes Aires,
una vez per mes y per varies dias y ha side prepueste ceme “ adscripte
honerarie” al misme. Estames tratande de ebtener una beca para un
oricntalista que deberia ecuparse en nuestre Institute de histeria de la
ciencia arabe. Y tenemes en vista etras gestienes para poder aumentar
nuestras entradas, nuestre persenal cientifice y nuestra biblieteca.

Ahera bien. En este punte nes ha parecide cenveniente influir sebre el
ambiente, erganizande algunas reunienes que llegaran a ser el semillere
de dende surgiran nuestres celaberaderes y dende se fermaran les jovenes
aptos para la laber futura. Organizar tales reunienes ne es cesa tan facil,
come puede parecer a primera vista. Curses de cenferencias, a las cuales
pudiera cencurrir el gran publice, y en las que eraderes cenecides hicieran
ostentacion de su sabiduria y de su retorica, ne nes parecia empresa cen¬
veniente, e mejer, apta para preparar un ambiente tranquile de estudies
severes. Per etra parte, un “ seminarie ” en el sentide cen el cual se aplica
esta palabra en las universidades, ne era cesa actualmente factible. Un
seminarie, en general, es una reunion de estudiantes que, bajo la direccion
del profesor de la materia, hacen ejercicios o desarrollan un tema indi-
cado per el profesor. Ahera bien, no es que me oponga a un seminarie
de esta naturaleza; pero para constituirlo es necesario que exista un deter-
minado numero de estudiantes que quieran perfeccionarse y trabajar en la
materia ensehada per el profesor. No es necesario que agregue que actual¬
mente en la Universidad del Litoral, y particularmente en Santa Fe, no
hay estudiantes que se interesan especialmente en la histeria de la ciencia,
y que esta disciplina no esta todavia comprendida en ningun plan de
estudies que lleve a la obtencion de un titulo doctoral u otro. Quiza dentro
de algunes anos, per nuestres esfuerzos y per el desarrollo creciente de
este Institute, sera posible tener un curse de esta naturaleza; pero per el
memento debemos inclinarnos ante la situacion de facto.

Per eso nos ha parecide come mejer solucion la de organizar algunes
“Coloquios” entre personas que, en ramas diferentes del saber, se han
ocupado de cuestiones historicas, escogiendo para ello un asunto fijo
(segun una division cronologica, o topografica, o tematica) para lograr
la unidad del conjunto, en el cual dicho asunto seria examinado desde
distintos puntos de vista. Ademas tales reunienes no deben ser publicas,
en el sentide ordinario de la palabra, pero admitimos en ellas, ademas de

208

ALDO MIELI

los designados para las disertaciones, todas las personas que verdadera-
mente quieren tomar una parte activa en nuestros trabajos, en particular
aquellos estudiantes que quieren formarse una cultura historica tal que
les habilite mas tarde a investigaciones y a trabajos originales.

Nos habian sugerido la realizacion de reuniones, y en particular la
inaugural, en Buenos Aires, dando a esta (y a las siguientes) gran publi-
cidad, y adoptando un tema que diera lugar a investigaciones personales,
en particular de documentos de archivo, o de libros raros, olvidados o
desconocidos. No hemos creido conveniente adherir a esas sugestiones.
Memos ya dicho que no queriamos hacer gran publicidad, con la cual,
muchas veces, frente a un exito aparente, se pierde verdadera eficiencia
cientifica. En cuanto a transferir algunas de las reuniones a Buenos Aires,
semos decididamente contrarios, porque los “ Coloquios ” deben ser una
emanacion directa y exclusiva de nuestro Instituto; por lo tanto esas
reuniones deben realizarse en sus locales o en las inmediaciones de estos
y solo en casos excepcionales, mas lejos, pero siempre en el ambiente de
la Universidad Nacional del Litoral. Reuniones de una naturaleza tal
como las que nos ban sugerido desde Buenos Aires, pueden, si, ser pro-
movidas por grupos adheridos a la Academia Internacional de historia de
las ciencias, y, precisamente, tenemos en la capital federal argentina una
“ Junta ” reconocida por la mencionada Academia. Por ultimo, no descono-
cemos la importancia que tiene el proponer temas que requieran bastante
trabajo de parte de los participantes a los “ Coloquios.” Sin embargo nos
parece que imponer una tarea bastante intensa a nuestros colaboradores
no es conveniente por el momento, y que esto no podra realizarse sino
cuando el funcionamiento de estas reuniones este mas adelantado, y a ellas
contribuyan personas que se dediquen exclusivamente o principalmente a
la historia de la ciencia. Seria inconveniente pretender de las personas
que con tanta gentileza empiezan a dar vida a nuestros ” Coloquios,” que
se recarguen con tareas fatigosas que requieren para su realizacion un
tiempo bastante largo. Es por esto que para los primeros “ Coloquios ”
hemos escogido un tema suficientemente amplio y que pueda encauzar
hacia un rumbo feliz nuestra iniciativa.

El tema que proponemos este ano es El desarrollo de la ciencia en la
primera mitad del siglo XIX. Quiza puede aparecer demasiado amplio o
de asunto demasiado conocido. Sin embargo, para la primera serie de
nuestras reuniones, no es este un defecto, por lo menos asi me parece.
Con el curso del tiempo se delinearan cada vez mas las caracteristicas de
los “Coloquios” y sera posible delimitar de una manera mas precisa la
amplitud de los acontecimientos que queremos estudiar. No debemos

LA HISTORIA Y LA FILOSOFIa DE LA CIENCIA

209

olvidar que en los primeros tiempos sera necesario crear el ambiente
cultural que nos permitira mas tarde una labor selectiva mas provechosa.

♦ 4 > 4 >

El panorama que nos ofrece la primera mitad del siglo XIX, entendida
en sentido inteligente, y no como un intervalo infranqueable, Hmitado por
las dos barreras 1801 y 1850, es verdaderamente interesante y nos muestra
ya el camino que las ciencias debian recorrer durante mas de un siglo.

Quiza los acontecimientos mas interesantes y profundos que inauguran
esta epoca son la nueva teoria quimica, completada por Antoine-Laurent
Lavoisier en 1789, y el descubrimiento de la electricidad dinamica con la
corriente el^trica que se obtenia utilizando la famosa “pila,” inventada
y construida por Alessando Volta en 1800.

La nueva teoria quimica, que dio fin con una feliz sintesis a un periodo
fecundo de investigaciones y que establecio firmamente el concepto de
elemento, dando ademas el metodo experimental exacto para reconocer
aquellas substancias que (desde el punto de vista quimico) no podian
descomponerse mas en sus componentes, permitio que se plantearan nuevos
problemas. Gran parte de estos encontraron solucion aproximadamente en
la primera mitad del siglo. Empezando con el descubrimiento efectivo de
los metales alcalinos, debido a Humphry Davy en 1807 y de los alcalino-
terreos, debido tambien al mismo sobresaliente experimentador, la mayoria
de los principales elementos terminaron por descubrirse en la primera
mitad del siglo. Ademas, las consideraciones y experiencias de John
Dalton, que atribuian un “ peso de combinacion ” caracteristico para cada
uno de los elementos, abrieron un campo totalmente nuevo de la quimica
teorica. Las aparentes contradicciones que surgieron con la ley de los
volumenes de Gay-Lussac, que una ingeniosa intuicion de Amadeo Avo-
gadro habia casi llegado a resolver, despues de varias teorias, entre las
cuales conviene recordar la electroquimica de Berzelius, ya de un periodo
de extrana confusion, llegaron a su completa aclaracion con el Sunto de
Stanislao Cannizzaro; asi la teoria atomica moderna, que a pesar de su
nombre y de las creencias contemporaneas, puede concebirse de una manera
perfectamente independiente de una hipotetica estructura corpuscular de
las substancias, llega con este sobresaliente sabio siciliano a una forma que
persiste todavia y que es inquebrantable en sus fundamentos.

Por otra parte el descubrimiento de la corriente el&trica, mientras
condujo inmediatamente a conocer los fenomenos de electrolisis, tan impor-
tantes para la pratica y teoria quimicas, dio lugar a trabajos fundamentales
sobre su naturaleza y sus leyes: trabajos que culminan con el Traite

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ALDO MIELI

mathematique des phenoniftnes electro-dynamiques uniquement deduit dt
rexperience (1826) de Andre-Marie Ampere, con Zur Entdeckung des
Elektromagnetismus (1820) de H. C. Oersted, y con Die galvanische Kette
(1827) de Georg Simon Ohm, para dar pronto lugar a la obra trascen-
dental y compleja de Michael Faraday (1832-1850), el humilde auxiliar
de Davy, que, segun este decia, habia sido su mayor descubrimiento.

Pero no son solo estos los fenomenos fundamentales descubiertos o
cuidadosamente estudiados en la fisica y en la quimica durante la primera
mitad del siglo XIX. Dejando de mencionar muchos otros, recordamos
como la teoria del calor, que estaba desprendiendose paulatinamente de la
Concepcion que de el se tenia como de una “materia del calorico” para
asumir la de una “energia” — que para algunos era, y es todavia, un
movimiento de las hipoteticas moleculas — a traves de las investigaciones
de Sadi Carnot, que puede llamarse el creador del segundo principio de la
termodinamica, llego con Robert Mayer, James P. Joule y Hermann von
Helmholtz a concretar su primer principio, el de la conservacibn o persis-
tencia de la energia, preparando asi el camino para una energetica completa.

En la optica, por obra de Thomas Young y de Augustin Fresnel resurge
a nueva vida y alcanza un desarrollo completo la teoria ondulatoria de la
luz, que, ya imaginada por Christiaan Huygens, debia dominar de una
manera indiscutida durante todo el siglo XIX. Y en la quimica, la de los
compuestos del carbono empieza su glorioso camino ascensional, mientras
que, comenzando con la sintesis de la urea (Wohler, 1827), el intimo
conocimiento de otras substancias organicas se multiplicaba incesante-
mente, borrando la divisibn artificial entre las substancias que se suponian
originadas sblo bajo la influencia de la vida, y las otras que se producian
por las comimes reacciones inorganicas. Entre tanto la gran industria
quimica revolucionaba no sblo al campo de la ciencia, sino tambien al de
la vida social. Y mientras se desarrolla portentosamente la industria
mecanica y la termica, los buques a vapor y los ferrocarriles con loco-
motores inauguran un nuevo periodo en las comunicaciones maritimas y
terrestres.

No menores son los progresos que, a ambos lados de este grupo central
de las ciencias fisico-quimicas, realizan la disciplinas matematicas y
astronbmicas, y las biolbgicas, puras y aplicadas.

El primer dia del siglo (el 1° de enero 1801) Giuseppe Piazzi descubrio
el primer planetoide, que denominb Ceres, con lo que se inaugura el conoci¬
miento de una nueva serie de miembros del sistema solar. La importancia
de este descubrimiento no reside sblo en este hecho, sino tambien a que
Piazzi habiendo podido observar el camino aparente del nuevo planetoide

LA HISTORIA Y LA FILOSOPfA DE LA CIENCIA 211

sobre la esfera celeste, solo para nueve grados, antes de su desaparicion,
Gauss, con gran maravilla de los demas astronomos pudo calcular con
exactitud su lugar en la epoca de la reaparicion, empleando un nuevo
metodo, el de los “ cuadrados minimos.” Pero acontecimientos de mayor
importancia, aunque no acaecidos exactamente en el primer dia del siglo,
marcan en astronomia el comienzo de la epoca que debemos tomar en
consideracion. Los cinco volumenes de la Mecanique celeste de Pierre-
Simon Laplace vieron la luz desde 1798 hasta 1825 y no es menester que
destaquemos lo que significa esta obra para el progreso de la ciencia.
Hablando de Laplace como astronomo no puede silenciarse el nombre del
sobresaliente matematico Joseph-Louis Lagrange, fallecido en 1813, cuya
obra astronomica puede en parte igualarse a la de su colega f ranees. Por
otra parte, mas en el campo de la astronomia descriptiva que en el de la
matematica y gravitacional, a horcajadas de los dos siglos se encuentra
la excepcional figura de Friedrich Wilhelm (Sir William) Herschell
(1738-1822). El obscuro musico de Bath se volvio de repente celebre
cuando el 13 de marzo 1781 descubrio un nuevo planeta, Urano, que venia
de agregarse asi a los siete unicamente conocidos desde la mas remota
antigtiedad; pero ni este descubrimiento, ni el perfeccionamento que aporto
a los instrumentas astronomicos de observacion, ni el gran adelanto que
realize en el conocimiento del sol y del sistema solar, tienen aquel caracter
de novedad en la astronomia como lo tuvo su “ sondeo ” del cielo, su
estudio de las nebulosas y de los movimientos de las estrellas dobles, su
Concepcion de los “ 1500 universes” que el decia haber descubierto, sus
intentos de juzgar las distancias a las distintas estrellas, y otros resultados
que inauguran triunfalmente, puede decirse, la astronomia estelar.

No trataremos los restantes progresos realizados en el periodo que
queremos considerar, solo recordaremos como con Fraunhofer y con la
espectroscopia empieza a estudiarse con provecho la fisica y la quimica de
los cielos y como la mitad del siglo termina, aproximadamente, con un
triunfo de la teoria gravitacional, cuando, en 1846, se encontro im nuevo
planeta, Neptuno, cuya existencia y cuya 6rbita habian side previstas y
calculadas por Leverrier, considerando las irregularidades observadas en
la orbita de Urano.

Hemos ya mencionado el nombre del turines Lagrange, al cual todas
las ramas de la matematica le deben un adelanto prodigioso y cuya obra
maestra, pero una de las tantas extremadamente valiosas, la Mecanique
analytique, estaba apareciendo en su segunda edicion cuando el murio
(el segundo volumen es postumo). Es notorio que su contemporaneo
Gaspard Monge (muerto en 1818) renov6 y creo nuevas ramas de la

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ALX>0 MILLI

geometria. Como un meteoro paso la breve vida de Niels Hendrik Abel
(1802-1829), mientras Augustin-Louis Cauchy (1789-1857) en su larga
vida y Joseph Fourier (1768-1830) en su mas breve, desarrollaban
enormemente el analisis, introduciendo un rigor, antes desconocido, en el
calculo infinitesimal y dando un impulso excepcional a la f isica matematica,
respectivamente. En este medio siglo domina la figura de Johann Friedrich
Gauss (1777-1855), sabio que abarco todo el campo de la matematica y
de las ciencias afines (astronomia, magnetismo, etc.). For su universalidad
puede casi decirse que el fue, para su epoca, lo que Euler fue para la mitad
central del siglo XVIII. El nombre de Gauss se vincula tambien a las
geometrias no-euclidianas que, en esta epoca, lograron su desarrollo espe-
cialmente por obra de Jan Bolyai y N. I. Lobacevskij. Debemos ademas
subrayar la inauguracion de la teoria de los grupos de sustitucidn, obra
del casi milagroso muchacho Evariste Galois (1811-1832), quizas una
de las mentes matematicas mas grandes de todos los tiempos, y la con-
stitucion efectiva de la geometria proyectiva.

Por otra parte la asi denominada “ historia natural ” presenta un aspecto
no menos nuevo y confortante. Abandonada, con el siglo XVIII, la mania
clasificatoria, especialmente la artificial, los naturalistas se dirigen hacia
un examen mas profundo de la vida y de la naturaleza de las funciones
de los seres organizados. Si el fendmeno de la respiracion de los animales
habia quedado (provisoriamente) completado con Lavoisier y Spallanzani,
el otro de la respiracidn y asimilacion de las plantas llegd con Ingenhousz,
Senebier y Theodore de Saussure a su esclarecimiento (tambien provi-
sorio) en los primeros decenios del nuevo siglo. En su con junto la
fisiologia debe sus mayores progresos a Johannes Muller (1801-1858).

Como descubrimientos notables de la epoca que estudiamos deben
mencionarse: el del huevo de los mamiferos, debido a Ernst von Baer
en 1827, y el otro, mas trascendental, del reconocimiento de las celulas
como constituyentes de todo organismo, animal y vegetal. Ya mas de un
siglo antes, Marcello Malpighi habia visto y dibujado alguna celulas vege-
tales, pero no las habia considerado como elementos esenciales de los
tejidos. Es por obra de Theodor Schwann (1810-1882) y de Mathias
Jakob Schleiden (1804-18881), apoyados por el mencionado Johannes
Muller, que se constituyd la teoria celular que debia ser de importancia
fundamental para la comprension de la anatomia y fisiologia de los seres
organizados.

En otro sentido dio la “historia natural” un paso extraordinario.
Georges Cuvier (1760-1832) con sus cuidadosos estudios sobre los ani¬
males (vertebrados) vivientes y los de las epocas geologicas pasadas,

LA HISTORIA Y LA FILOSOfIa DE LA CIENCIA

213

llego a un grade tal de perfeccion como para poder reconstruir el esqueleto
complete de un animal teniende tan sole una pieza de el. Puede en verdad
considerarselo como el fundador modemo de la anatomiai comparada (no
debe olvidarse que esta ciencia ya tuvo con Aristoteles un profundo
desarrollo) y de la paleontologia de los vertebrados. A1 mismo tiempo
Jean-Baptiste Monet, chevalier de Lamarck (1744-1829), sabio bastante
extrano, cuyas ideas extravagantes en quimica, meteorologia y otras
disciplinas, lo habian desacreditado bastante y obstaculizaron momen-
taneamente la difusion de otras, verdaderamente geniales, desarrollaba,
mucho mas alia de Cuvier, los conocimientos acerca de los animales
entonces denominados invertebrados. Pero donde reside la mayor, y
merecida, celebridad de Lamarck, es en el desarrollo de las ideas evolu-
cionistas (la adaptacion al ambiente, el efecto del uso y del no uso de las
partes, la herencia de las propiedades adquisidas) que, combatidas por
Cuvier, hombre de conocimientos solidos, pero carente de vuelos fantasti-
cos, tambien de los geniales, fueron, en cambio promovidas y ampliadas
por Etienne Geoflfroy Saint-Hilaire (1772-1844). Nos encaminamos asi
hacia Darwin, cuya obra principal en este sentido. The origin of the
species by means of natural selection, es de 1859, pero que ya antes de
esta fecha vislumbraba su teoria, contemporaneamente, pero independente-
mente a A. R. Wallace, en el campo naturalistico, pero en sentido algo
diferente, y a Herbert Spencer, en un campo mas filosofico y sociologico.

Con el nombre de Cuvier se liga estrechamente, en la geologia, la teoria
de las “ catastrofes,” que, por la gran autoridad del sabio f ranees, mantuvo
su predominio en los primeros decenios del siglo XIX. Ella estaba en
armonia con la suposicion de la estabilidad de las especies y en manifiesta
contradiccion con las teorias evolucionistas. Pero, ya antes de la muerte
de Cuvier, aparecian (1830-1832) los Principles of Geology de Charles
Lyell (1797-1875), que reanudandose a las doctrinas de James Hutton-
y de su escuela, destruyeron completamente las teorias de las catastrofes,
introduciendo el “ actualismo,” fundamento de la geologia moderna. La
teoria de Lyell en sus principios estaba conforme con la teoria de la evo-
lucion a la cual Lyell adhirio completamente cuando tomo fuerza con
Darwin, y que sostuvo en los escritos de la segunda mitad de su larga vida.

No ocurre, por lo que se refiere a las ciencias de naturaleza inorganica,
recordar como en el medio siglo que consideramos, la mineralogia encontro
su clasificacion adecuada en la composicion quimica de los minerales y en
su forma crestalografica. Ademas la geografia fisica se convirtio en
ciencia independiente, principalmente con la obra de Alexander von
Humboldt.

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No queremos aqui ocuparnos de las aplicaciones, como las disciplinas
niedicas y la agricultura, ni senalar los progresos que en esta primera
mitad del siglo cumplieron las ciencias historicas, las filologicas, las socio-
logicas y econotnicas, y otras de naturaleza semejante. Tampoco trata-
remos de la filosofia que en esta epoca se distancio notablemente de las
ciencias verdaderas para seguir sus utopias metafisicas y sus razona-
mientos inconcludentes. Por otra parte la filosofia positivista, que queria
basarse sobre la ciencia, tiene una pobreza tal de contenido, una tal extre-
mada simplicidad intelectual, y una tal abundancia de sentimientos pre-
concebidos y religiosos (la religion comtiana!), que apenas puede tener
importancia como manifestacion cultural. Espero, con todo, que algunos
de los colaboradores de los “ Coloquios ” traten estos temas.

Solo quiero agregar que, para nosotros que vivimos en America, interesan
de una manera especial los estudios concernientes a este continente, sobre
todo a su parte meridional. Asi un especial interes sentimos hacia los
trabajos de los “ americanistas,” asi como por los viajes de los naturalistas
a traves de estas regiones, que comienza, puede decirse, por el periodo que
nos interesa, con Felix de Azara, Alexander von Humboldt y Bonpland,
se continuan con Darwin, Fitzroy y D’Orbigny, mientras estudios de
igual naturaleza aparecen tambien en autores cuyos intereses se dirigen
principalmente a otros aspectos de la vida de la America meridional. De
todas estas cuestiones, en el limite del tiempo disponible, queremos ocu- '
parnos en estos “Coloquios,” dandoles asi al mismo tiempo un aspecto
conforme a la internacionalidad de la ciencia, sin descuidar lo que interesa
a nuestra parte del continente, en especial a la Argentina.

Si el costo de la publicacion sera accesible a nuestro limitado presu-
puesto, no dejaremos de publicar las comunicaciones que se haran en los
“ Coloquios,” en un tomito de las “ Publicaciones ” de nuestro Institute,
esperando poder continuar en el mismo sentido con los “Coloquios” i

de los anos venideros.

Y, con esto, termino estas breves palabras de introduccion, senalando
en orden alfabetico de autores, las comunicaciones que ya algunos de
nuestros colaboradores nos ban asegurado:

Jose Babini, El nacimiento de las geometnas no-enclidianas. j

Rosa D. de Babini, Viajeros extranjeros en la primera mitad del siglo li
XIX en la Argentina.

Mario Bunge, Faraday y el desarrollo de la teor'ia de la electricidad.

Gustavo A. Fester, El desarrollo de la gran industria. ii

Josue Gollan (h), El nacimiento y el desarrollo de la qutmica agricola. |j

Andrea Levialdi, El desarrollo de la astrofisica. | *

LA HISTORIA Y LA FILOSOFIa DE LA CIENCIA

215

Francisco J. Menchaca, Introduccion, en la prdctica medica, de la aus-
cultacion y de la percusion.

Aldo Meili, El desarrollo de la teoria atomica moderna.

Simon M. Neuschlosz, El origen de la teoria de las cilulas.

Cortes Pla, El advenimiento de la termodindmica.

Ricardo Resta, La filologia en la primera mitad del sigh XIX.

Angela Romera Vera, Panorama politico y cultural de principios del
sigh XIX.

Jose Luis Romero, El romanticismo y la historia de las ideas.

Marta Samatan, La pedagogia en la primera mitad del sigh XIX.

Rafael Virasoro, Las corrientes filosdficas de la primera mitad del
sigh XIX.

Agustin Zapata Gollan, Los americanistas de la primera mitad del
sigh XIX.

L’articolo precedente era il discorso di inaugurazione che dovevo pronunciare il
1° agosto (1943) alia prima riunione dei “ Coloquios ” organizzati dal nostro
Institute de historia y filosofia de la ciencia. Gia il 25 luglio erano stati diramati
gli inviti per assistere alia seduta, e con giubilo aspettavamo I’inizio di questa
nuova attivita nostra, dalla quale ci aspettavamo un nuovo incremento della nostra
azione. Ma il 28 luglio, il nuovo governo argentino, sorto dalla cosidetta “ rivolu-
zione ” del 4 giugno, interveniva la Universidad Nacional del Litoral, nominando
come interventore un tal Jordan B. Centa, un professore di psicologia, entusiasta
ammiratore della metahsica (ma di quale? quella puramente reazionaria?) e di
Aristotele (ma non del vero Aristotele, il grande ed immortale scienziato greco,
di quello invece che invocano tutte le persone retrive ed ignoranti). Non e il
memento opportune, questo, per fare commenti su questa intervenzione, che colpiva
una delle piii valorose e progfressive universita argentine, e su altri avvenimenti
con questa collegati. Senza accennare nemmeno a vari professori cacciati fine ad
ora (19 settembre) dal loro posto, od ai duemila studenti espulsi (fine a quandof)
dairUniversita, faremo solo una breve e nuda cronaca dei pregiudizi sofferti dal
nostro Institute e dal suo direttore.

Appena giunto, I’interventore si occupo del nostro Institute, che, ai suoi occhi,
non godeva certo di odore di santita, per il suo spirito assolutamente internazionale,
per la rivista che accoglieva la collaborazione di scienziati di tutti i paesi, di tutti
i seguaci di credo politici e religiosi, in tutte le lingue accessibili alia generalita
delle persone colte. I locali, poi, nei quali I’istituto era situate, facevano gola per
un uso private di essi. Fatto sta que fin dai primi momenti il suo direttore fu
minacciato di provvedimenti per la rescissione del contratto che lo legava all’Uni-
versita, mentre la biblioteca e gli altri eflfetti dell’Instituto furono fatti sloggiare in
due giorni, per essere trasportati alia rinfusa in un magazzino, dove non solo non
si poteva continuare a lavorare, ma anche la ricerca di uno dei seimila volumi che
possediamo o dei cinquemila opuscoli si assomiglia alia classica e tradizionale ricerca
di un ago sperduto in un grande pagliaio. In avvenire faremo commenti a questi
provvedimenti che mostrano non solamente una mancanza dei piu elementari

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ALDO MIELI

riguardi verso una persona, e di questo ce ne infischiamo altamente, ma anche un
disprezzo inconcepibile verso ogni e qualsiasi azione culturale e un attacco mancino
e ipocrita contro una organizzazione che era, lo possiamo proclamare altamente c
con fierezza, di lustro e decoro per la Repubblica Argentina, e che, in un determi-
nato campo scientihco, la collocava in prima linea fra le altre nazioni civili. di
quest’ultimo fatto ci doliamo acerbamente.

Ma peggio ancora doveva awenire. II 18 settembre (giorno nel quale scriviamo
questo appunto) fu comunicato al direttore dell’Instituto, che, appoggiati ad un
giudizio dato da un tal awocato Villanueva, che pare sia il legale che, in Santa Fe,
si ricerca per gli affari piu loschi, si consideravano nulle le convenzioni fra I’llni-
versita ed Aldo Mieli, e quindi con il 1° ottobre dell’anno si considerava questi
separato dall’Universita. I considerando speciosi e vergognosi si potranno leggere
nel documento citato che, senza chiederne la pubblicazione, allego alia presente nota.
Fra i primi si menziona il fatto di non avere tenuto corsi; fatto che come a tutti e
notorio dipese dalla mia malattia di tre anni, per la quale per mesi e mesi e reiterata-
mente fui ricoverato in un sanatorio, e che fu riconosciuto dalle autorita universi-
tarie, consentendo, queste, che in altra maniera dispiegassi la mia attivita, che,
d’altronde, non venne mai meno, nemmeno nei peggiori momenti. Fra gli ultimi,
vergognosi per chi li ha emessi e per chi direttamente o indirettamente li ha ispirati,
noto le tirate nazionalistiche che caratterizzano I’attuale regime argentino, e che
tendono ad escludere dal concerto delle nazioni civili questo disgraziato paese.

Noto anche che della rivista “ Archeion ” fu fatto affrettatamente pubblicare
I’ultimo numero dell’annata, che, come numero 2, era gia quasi completamente
pronto, e che in questi giorni sta in distribuzione. In seguito la pubblicazione di
“ Archeion,” ben inteso in questa universita, e stata soppressa. Non importa accen-
nare che “ Archeion ” fu da me fondato nel 1919 e che continuera a vivere,—non
sappiamo ancora ne dove ne come—merce I’appoggio che sempre gli fu dato nel
campo intemazionale dai suoi abbonati, e dai generosi sussidi di numerose societi,
accademie e perhno da parecchi governi. Citiamo fra questi ultimi quelli di Italia
(auspice Benedetto Croce), di Francia, della Spagna repubblicana, della gloriosa
Polonia, dell’infelice Rumania, della Germania prehitleriana, ed altri.

Comunque sia, e chiaro che la riunione del 1°" agosto non pote piu aver luogo.
fi per questo che, tanto per documentare quanto facemmo nell’Istituto da noi diretto,
quanto per stigmatizzare I’opera di coloro che stanno deg^'^dando il nome e la vita
della nobile nazione argentina, che noi, dico, approfittando della squisita cortesia
del carissimo amico Henry E. Sigerist, pubblichiamo il nostro (non pronunciato)
discorso inaugurale e questa breve aggpunta, nel volume dedicate nel Bulletin of
the History of Medicine all’amico Arturo Castiglioni, altro perseg^itato politico,
che dovette lasciare la sua Trieste per riparare dalle persecuzioni fascite nella libera
e gloriosa repubblica nordamericana, la patria di Franklin e di Washington, dalla
quale, insieme ai suoi alleati, fra i quali la vecchia Inghilterra, la eroica repubblica
sovietica, e non ultima, spero, ITtalia ormai liberata ed antitedesca, aspettiamo lo
sterminio definitive e complete del fascismo e della tirannia, sia quelli ostentati in
forma aperta e brutale, sia quelli mascherati in forma larvata ed ipocrita, sussistano
ancora in alcuni paesi. E mentre invio a Sigerist il mio riconoscente ringraziamento,
a Castiglioni il mio piu cordiale salute, mi propongo, in questi pochi anni che ancora
mi rimangono di vita, di proseg^ire, senza titubanze e senza rimorsi, il cammino
che, senza disviamenti, ho continuato a percorrere durante la mia or gia lunga
esistenza.

DIRECTIONS FOR THE USE OF AN EARLY AMERICAN
MARINE MEDICINE CHEST

GENEVIEVE MILLER

The custom of carrying a medicine chest on sea-going vessels has
obviously prevailed at all times. Illness and accidents were inevitable
occurrences, and provision had to be made to treat them. The navies of
the various countries generally provided surgeons to care for their sick
sailors, but fishing and merchant vessels relied upon the skill of the captain
or one of his mates, who with little medical knowledge simply followed
the directions which accompanied the ship’s medicine chest. The same
procedure is followed today in most vessels of the merchant marine and
in auxiliary naval vessels which because of their size or for some other
reason have no medical man aboard.^

One of the laws passed by the first American Congress in 1790,
“ An Act for the government and regulation of Seamen in the merchants
service,” contained the following paragraph: *

Sec. 8. And be it [further] enacted. That every ship or vessel belonging to a
citizen or citizens of the United States, of the burthen of one hundred and fifty
tons or upwards, navigated by ten or more persons in the whole, and bound on a
voyage without the limits of the United States, shall be provided with a chest of
medicines, put up by some apothecary of known reputation, and accompanied by
directions for administering the same; and the said medicines shall be examined
by the same or some other apothecary, once at least in every year, and supplied
with fresh medicines in the place of such as shall have been used or spoiled; and
in default of having such medicine chest so provided, and kept fit for use, the master
or commander of such ship or vessel shall provide and pay for all such advice,
medicine, or attendance of physicians, as any of the crew shall stand in need of in
case of sickness, at every pori or place where the ship or vessel may touch or trade
at during the voyage, without any deduction from the wages of such sick seaman
or mariner.

In 1805 the Act was amended to extend to merchant vessels “of the
burthen of seventy-five tons, or upwards, navigated with six persons or
more, in the whole, and bound from the United States to any port or
ports in the West Indies.” ®

' Cf. Medical Compend for Commanding Officers of Naval Vessels to Which no Member
of the Medical Department of the United States Navy Is Attached. To accompany Medi¬
cine Box. U. S. Bureau of Medicine and Surgery, Washington, 1942;—W. L Wheeler, Jr.,
Shipboard Medical Practice, a Handbook of Ship Sanitation and Emergency Medical Aid
at Sea. New York, Cornell Maritime Press, 1943.

'First Congress. Session II, Chap. XXIX. Statute II, July 20, 1790.

f Eighth Congress, Session II, Chap. XXVIII. March 2, 1805.

217

218

GENEVIEVE MILLER

As a result of this legislation, many pamphlets were published which
provided directions for the use of medicine chests. One such pamphlet
was that published in Baltimore in 1806 with the title:

New and Improved Directions for the Use of the Medical
Compositions contained in the Marine Medicine Chests, prepared
(agreeably to act of Congress) by James Hanna,* at his medical
warehouse. No. 102, Baltimore-Street, Baltimore. Baltimore,
Printed by Warner & Hanna, 1806.

It contains 24 pages altogether, beginning appropriately with 2j4 pages
on how “ To Recover Drowned Persons.” Then the contents of the chest

are listed, at the same time explaining what they are good for and instruct¬
ing the proper dosage. Finally the diseases, arranged in alphabetical order,
are presented with information concerning their treatment. The following
diseases are included:

Ag:ue

Bad Digestion
Bruises
Bums
Colic

Cold, or pains all over
Consumption

Coughs and Shortness of Breath
Clap

Costiveness

Dropsy

Fevers

Gleet

Gripes

Itch

Jaundice

Looseness and Bloody Flux

Measles

Pleurisy

Piles

Pox

Rheumatism
Scurvy
Small Pox
Strains
Wounds

Let us imagine that we are a ship’s captain to- whom a feverish seaman
comes for a remedy. Opening the medicine chest, we take out the pamphlet
and imder ” Fevers ” read the following:

If inflammatory, they are known by a pain in the head, a beating in the temples,
and gfiddiness after stooping down; also costiveness. Take half a pint of blood from

* James Hanna was a druggist whose name appears in the Baltimore directory between
1806 and 1810. The following advertisement was printed in the Feb. 6, 1807 issue of the
Baltimore American, and Commercial Daily Advertiser:

“Just opening. And for Sale by the Subscriber. Dr. Solomon’s Cordial Balm of Gilead,
Anti-impetigines, Guide to Health, &c. From Robt Bach & Co. sole agents for the
United States—with a general assortment of Drugs, Patent Medicines, &c. warranted
genuine and of the first quality. Also, Prussian Blues, from No. 1 to 3, of the first
qualities and at reduced prices—and Mephitic Air Machines, very handsome and low;
Glass Furniture, &. of all sizes, for sale wholesale and retail, by James Hanna, 102
Baltimore-street.”

THE USE OF AN EARLY AMERICAN MARINE MEDICINE CHEST 219

the arm, and at bed-time take a dose of N. If costive the next momingf, take a dose
of G. Should the complaint continue violent, bleed again the third day, and let a
dose of G. be dissolved in half a pint of water or gruel, of which take a table
spoonful every six hours. If a Putrid Fever, which is known by shiverings, pains
in the head and back, great weariness of the limbs, weakness and load at the
stomach, bitter taste in the mouth, great thirst, the tongue white and dry, a giddiness
in the head, light affects the eyes, and the mind wanders from one thing to another—
half a pint of blood may be taken from the arm any time within the first three days.
If the person is a stout healthy young man, and has not been affected from another
person in the fever, the first evening after bleeding, (or if not judged proper to
bleed,) as soon as the disorder appears, take a dose of N. if it should operate
violently, and open the bowels downwards, a dose of R. must be taken after its
operation.

Next day begin to take a dose of P. every four or six hours, till the person
recovers. If the patient is low, may occasionally give a dose of S. If restless at
nights, take a dose of R. every night at bed-time. If the fever is very violent, apply
a blister X. to the back of the neck. Port wine may be given, to the quantity of a
bottle a day, mixed with barley-water, or toast and water, for common drink. If at
any time P. opens the bowels, eight or ten drops of R. may be added to each dose.
If costive, a quarter of a dose of M. may be taken every two, hours, till a sto<^ is
procured. If a great weakness remains after the fever is abated, a dose of H. may
be added to P. twice a-day.

Thumbing through our little book, we find that N. consists of “ Fever
Powders ”:

One sixth part of one of these powders, taken in boiled water, every hour, being
undrest in the bed; and when they either vomit or purgfe, desist, and drink some
warm water. Proper in inflammations, fevers, pleurisy and colic: also after bleed¬
ing in fevers, bilious disorders, bloody-flux, small-pox, measles, and inflamed
rheumatism.

The purge G. prescribed the next morning consists of “Manna and
Salts”:

A Table spoonful or more according to the strength of the constitution, is a dose.

In the event of “ Putrid Fever,” N. the “ Fever Powders ” are followed
by R. “ Anodyne Drops ”:

Should be used cautiously, from fifteen to forty drops in the dose. When useful
I have mentioned under different heads, to which I must refer you. Proper in
violent purging, vomiting, colic, grripcs, gravel, cramp, fixed pains, great restlessness
in fevers, severe fatig^ue, want of rest, &c.

The next day doses of P. “ Peruvian Bark ” are begim, with an occasional
dose of S. “ Volatile Spirits ” :

From ten to thirty drops taken in a glass of wine or water, proper in sickness,
fainting, or palpitation of the heart: also for sore throats, &c. as directed under T.
[Emollient Oil].

220

GENEVIEVE MILLER

In case of very violent fever the “Blistering Plaister” X. is applied as
follows:

In fevers, accompanied with a very low pulse, ramblingfs, and frequent starting,
this plaister spread upon leather, and applied to the neck, arms, and legs, according
to the danger of the patient, will be likely to do g^reat service. It should lay on
from twelve to twenty-four hours: then cut the blister, and dress it with No. 2.
[Healing Cerate] spread thin upon soft linnen. In spreading the blister plaister,
the knife should be just warm. If the plaister should cause a stranguary, let the
patient drink plentifully of strong barley-water or biscuit tea, which is made by
pouring boiling water on bruised or powdered biscuits. Blisters are also of great
service in stitches of the side and breast, applied on the part. About the size of a
man’s hand is sufficient for the back or side: those for the arms, legs, &c. must be
smaller. Blisters behind the ear are also proper in case of severe tooth-ache, pain
in the head or face.

The custom of referring to drugs by letters or numbers, without men-
j tioning their names, was very common throughout the nineteenth century.

I In a handbook of this type the chief object was to present the information

\ in the most concise manner with due regard to the possible illiteracy of

[ the ship’s commander.®

i Except in a few cases, the pamphlet does not designate the specific

I name of the drugs included in the chest. They are given general names

■ such as “Vomiting Powders,’’ “Corroborant Elixir,’’ or “Healing

I Vulnerary Balsam.’’ By consulting other such pamphlets and the dis-

• liensatories of the period,® the contents of our particular medicine chest

may be roughly established:

Probable Contents

A. Vomiting Powders.Tartar Emetic and/or Ipecac

B. Febrifuge Spirit.Solution of Ammonium Acetate

C. Opening Powders.Various purgatives such as jalap, senna,

magnesia, etc.

® Here I cannot resist quoting a tale relayed to me by Mr. Whitfield J. Bell, Jr. who
obtained it from a friend interested in New Bedford whaling in the 19th century:
“ One captain, whose chest must have been limited, found on consulting his volume that
the case before him required drug No. 13. But he had none of that drug, so (with a
startling directness!) he mixed up the drugs in bottles 8 and 5 and gave them! The man
recovered.”

* N. D. Falck, The Seanuin's Medical Instructor, London, 1774;—William Northcote,
The Marine Practice of Physic and Surgery, London, 1770, Vol. I;—^John Redman Coxe,
The American Dispensatory, Philadelphia, 1806;— The Pharmacopoeia of the Massachusetts
Medical Society, Boston, 1808;—^James Thacher, The American New Dispensatory, Boston,
1810;— The Pharmacopoeia of the United States of America, Boston, 1820. Dr. George
Urdang very kindly sent me information concerning a pamphlet entitled Medicine Chests,
Of All Kinds With Directions Suitable To Their Contents, ... by Daniel Henchman,
Boston, 1825 which contains almost the same drugs as our chest.

THE USE OF AN EARLY AMERICAN MARINE MEDICINE CHEST 221

D. Astringent Powders.

E. Castor Oil.

F. Sweet Spirit of Nitre.

G. Manna and Salts.

H. Corroborant Elixir.

I. Purging Bilious pills

K. Colic Mixture ^

L. Asthmatic Elixir.

M. Rhubarb.

N. Fever Powders®

O. Saline Powder.

P. Peruvian Bark.

Q. Healing Vulnerary Balsam

R. Anodyne Drops.

S. Volatile Spirits.

T. Emollient Oil.

U. Opodeldoc .

V. Pectoral Electuary*

W. Mercurial Solution

X. Blistering Plaister.

Y. Diachylon with the gums..

Z. Simple Diachylon.

No. 1. Strengthening Plaister....

No. 2. Healing Cerate .

No. 3. Digestive Ointment.

No. 4. Saturnine Extract.

No. 5. White pills.

No. 6. Blue stone.

No. 7. Caustic Powder.

No. 8. Balsam Capivi.

No. 9. Mercurial Ointment

Probable Contents
Alum
Castor Oil

Spirit of Ethyl Nitrite
Manna and neutral salts
Aromatic sulfuric acid

Paregoric

Rhubarb

Potassium carbonate
Cinchona

Compound Tincture of Benzoin

Laudanum

Ammonia water

Sulfurated or camphorated oil

Camphor and soap liniment

Cantharides Plaster
Lead oleate plaster with added sub¬
stances

Lead oleate plaster
Plaster of Red Oxide of Iron
[Ferric Subcarbonate]

Ointment of Calamine
Resin Ointment
Lead acetate
Calomel
Cupric sulfate
Potassium hydroxide
Copaiba

'A colic mixture in Northcote’s Marine Practice, Vol. I, Appendix p. 102 contained
the following ingredients: infusion and tincture of senna, syrup of buckthorn, and liquid
laudanum.

'Possibly the antimonial powder of the first U. S. Pharmacopoeia, 1820, p. 77, also
referred to as James’ Powder. The ingredients were sulphuret of antimony and hartshorn.

* Three recipes for pectoral electuaries in Northcote, /. c., pp. 52-3 contain the following:
1) conserve of rosa canina, spermaceti, crabstones, and syrup; 2) conserve of roses, balsam
of sulfurated turpentine [modem terebene]; 3) conserve of roses, powdered crab’s claws,
spermaceti, Peruvian balsam, and syrup.

“Contained lead oleate plaster, strained galbanum, turpentine and frankincense. Cf.
Thacher, 1. c., p. 388.

” Cf. Thacher, /. c., p. 389.

“Also called “Turner’s Cerate,” cf. Thacher, p. 384.

222 GENEVIEVE MILLER

Generally speaking, the contents of the chest compare very favorably
with modem chests for a similar purpose. The drugs selected were the
best ones available at the time for emergency medical treatment. They
were all useful and effective. Today new preparations such as aspirin,
phenobarbital, sulfadiazine, iodine, tannic acid jelly, vaseline, and pre¬
pared bandages have been added; but many of the older drugs (paregoric,
soap liniment, calomel, castor oil, aromatic spirits of ammonia, mercurial
ointment, etc.) are still retained.

SOME RELATIONS BETWEEN BRITISH AND GERMAN
MEDICINE IN THE SEVENTEENTH CENTURY

MAX NEUBURGER

The earliest indications of a connexion between British and German
Medicine or Surgery can be traced as far back as the 16th century. John
of Gaddesden’s Practica Medica, Rosa Anglica, was published by the
Durlach physician Philipp Schopff, with comments (Augustae Vindelic.,
1595). The oldest writing in the English language on gunshot wounds,
by Thomas Gale, An Excellent Treatise of Wounds made with Gonneshot
(London, 1563) is a polemic against certain surgeons who considered that
gunshot wounds were poisoned, as, for example, the famous German
surgeon Brunschwig (“Jerome Brunswicke ”). Lorenz Fries, in his
Spiegel der artseney, quotes Bartholomaus Anglicus and Gilbertus Angli-
cus. W. H. Ryff, in his work Die gross Chirurgei, mentions Gilbertus
Anglicus and Joannes Anglicus. One of the most celebrated English
surgeons of the 16th century, William Clowes, makes frequent references
to Paracelsus, in his work on gunshot wounds. John Banister published
a translation, with notes, of the work of J. J. Wecker, city physician of
Colmar: A Compendium chirurgery, gathered and translated especially
out of Wecker, London, 1585. Wecker was also quoted by Clowes. The
military surgeon John Woodall spent eight years in Germany at Stade
(Holstein) and acted as interpreter to an embassy sent there by Queen
Elizabeth. He travelled also in France and in Poland, treating cases of
plague. Later he was appointed surgeon to St. Bartholomew’s Hospital,
where he became acquainted with Peter Turner, a physician who, having
taken an M. A. degree at Cambridge, proceeded to obtain an M. D. at
Heidelberg in 1571.

The celebrated practitioner of Aberdeen, Duncan Liddle, had studied at
the universities of Frankfort a O., Breslau and Rostock and graduated
M. D. at Helmstadt in 1596. He was Professor of Medicine at the Uni¬
versity in Helmstadt from 1596 until 1607, and during this time he
became Dean of the Faculty of Philosophy and Pro-Rector of the
University.

The surgeon, John Hester, who described himself as a distiller or prac¬
titioner in the Spagirical Arte, published a number of translations from
the works of Paracelsus, who for years travelled all over Europe including
the British Isles.

223

224

MAX NEUBURGER

An excellent treatise teaching howe to cure the French-pockes, with
all other diseases arising and growing thereof, and in a manner all
other sickness. Drawne out of the bookes of Paracelsus. Compiled
by the learned Philippus Hermanns, and now put into English by
John Hester . . . London, 1590.

A hundred and fourteene experiments and cures of the famous
physitian Paracelsus translated . . . whereunto is added certaine
excellent and profitable workes by B. G. a Portu Aquitana . . . Col¬
lected by John Hester, London, 1598.

The chief work of the surgeon Felix Wuertz, a follower of Paracelsus,
the Practica der Wundartzney (Basel, 1596), appeared “ Englished and
much corrected ” by Abraham Lenertzon Fox . . . London, 1656.

In England the Pseudo-Paracelsists included John Michell, who came
from Antwerp to London and wrote an “ Apologia ” in which he lauded
Paracelsus to the skies, and Francis Anthony, an alumnus of Cambridge,
who in 1598 published a treatise Panacea aurea sen de aura potabili; but
the most famous of all the Paracelsists was Robert Fludd, a leading repre¬
sentative of that school of medical mystics which flourished particularly
in Germany during the seventeenth century. With less of original genius
than Paracelsus he had more method and took greater pains to frame an
harmonious system, blending in an extraordinary manner divinity, chemis¬
try, natural philosophy and metaphysics.^ As a student of medical science
he travelled on the continent for nearly six years, visiting France, Spain,
Italy and Germany, teaching in noble families; and he returned to his
native country with a considerable reputation as a proficient in chemistry.
Fludd’s success in the healing art was based on his influence on the minds
of his patients, and he and later William Maxwell were among the
earliest theorists with regard to animal magnetism and, indeed, the fore¬
runners of Mesmer.* Fludd is best remembered for his connexion with
the Fraternity of the Rosy Cross,® the movement of the Rosicrucians
having been commended to his notice by the German alchemist Michael
Mayer, who visited him in London. Mayer, offended in his patriotic
feeling by an epigram of John Owen published against the poet’s allusion

* Medicina Catholica, &c., Frankfort, 1629-31. Philosophia Moysaica &c., Gouda, 1638;
an edition in English, Mosaicall Philosophy, &c., London, 1659.

* Maxwell (Guillelmus). De medicina magnetica libri III . . . Edente Georgio Franco,
Francofurti, 1679. (Aus dem Lateinischen, Stuttgart, 1855).

* Apologia Compendiaria, Fratemitatem de Rosea Cruce suspicionis . . . maculis
aspersam, veritatis quasi Fluctibus abluens, &c., Leyden, 1616. (The assailant of the
Rosicrucians was Andreas Libavius).

BRITISH AND GERMAN MEDICINE IN SEVENTEENTH CENTURY 225

to a controversial treatise Verum inventum hoc est munera Germaniae,
ab ipsa primitus repertita (non ex vino, ut calumniator quidam sceptice
invehit, sed vi animi et corporis) et reliquo orbi communicata, etc., Franco-
furti, 1619.

Another Rosicrucian, devoted to the writings of Agrippa von Nettesheim,
was Thomas Vaughan, whose writings Introitus apertus ad occlusum regis
palatium (London, 1667) and Medulla alchymiae (London, 1667) were
translated into German. In the same way Sir Kenelm Digby’s Discours
sur la poudre de sympathie and his Medicina experimentalis appeared in
German editions (1672). Rudolf Goclenius, Professor of Medicine at
Marburg, attempted to explain by magnetism the remedial effect of the
famous “ weapon salve ” invented by Paracelsus. The sensation caused
by his writings started a controversy which dragged on for more than
fifty years, English opinion being represented by Fludd, William Foster
and Walter Charleton. Sebastian Wirdig, a professor at Rostock, spoke
on behalf of the divining rod and addressed his Nova medicina spiritum,
etc. (Hamburg, 1673) to the Royal Society of London.

Mystic, theosopho-cabalistic fantasies found far fewer adherents in •
England than in Germany, owing partly to a lack of natural taste for such
abstruse speculations, partly to the dawning of a more enlightened period.
Bacon’s criticism of the system of Paracelsus reads; “ Let no one adopt
the wild fancy of Paracelsus.”

As Bishop Sprat in the History of the Royal Society affirms, the Royal
Society was formed to carry out in practice Bacon’s experimental method.
The founding of the Society in 1660 was in a striking manner the formal
beginning of a new scientific era. By its motto of Nullius in Verba, its
Fellows were pledged not to be bound by the dictates of any school of
philosophy. They were to submit all questions to experiment, and they
were to express all their findings in the simplest and clearest words possible,
so that scientific knowledge would become accessible to everybody instead
of being jealously concealed in the mystic phrases of the adept.

In 1662 the Society received its charter from Charles II as the famous
Royal Society of London, and two years later it began to publish its
world-renowned Philosophical Transactions.*

‘The Royal Society is usually considered to have been founded in the year 1660, but
a nucleus had in fact been in existence for some years before that date. As early as the
year 1645 weekly meetings were held in London of “ divers worthy persons, inquisitive
into natural philosophy and other parts of human learning, and particularly of what hath
been called ‘ The New Philosophy or Experimental Philosophy and there can be little
doubt that this gathering of philosophers is identical with the “ Invisible College.” Its
regular meetings took place at the suggestion of Theodor Haak of the Palatinate, who

226

MAX NEUBURGER

In Germany the attempt to bring about a change of outlook in the
handling of questions relating to medicine and to natural science was set
on foot by the mathematician, physician and great botanist Joachim Jung.
In the true Baconian spirit he demanded that “ Naturphilosophie ”—
which expression he used in the sense of “ the natural philosophy of the
English ”—should concern itself not with final causes but with efficient
material causes. Owing, however, to the confusions of the Thirty Years’
War, the natural science society founded by Jung at Rostock ® had but
a brief existence, and with it Jung’s influence upon German learning came
to an end.

Nevertheless, some years after the war, in 1652, Johann Lorenz Bausch,
Joh. Mich. Fehr, G. Balth. Metzger and G. Balth. Wohlfarth founded the
Collegium Naturae Curiosorum, which, in 1677, became the Academia
Caesarea Leopoldina-Carolina. Shortly afterwards it began the publica¬
tion of a Miscellanea curiosa sive Ephemerides medico-physicorum ger-
manorum, which took high rank among the scientific publications of the
seventeenth century. J. P. Wurfbain, Director of the Ephemerides, had
made a study tour through Holland and England.

Meanwhile—before the appearance of Bacon’s Novum Organum and
independently of it—^the application of the methods of observation, ex¬
periment and induction had already proved triumphant in Harvey’s
brilliant achievement, the discovery of the circulation of the blood. Ex
ipsa Anglia exstitit novum artis lumen, cuius nomen ab ipso retro Hippo-
crate in medicina secundum est. {Haller)

In 1636 William Harvey left England in attendance upon Thomas
Howard, Earl of Arundel, who was sent as ambassador to the Emperor,
Ferdinand II. In the course of his journey he endeavoured by experiments
to convince Caspar Hofman, the learned professor at the Nuremberg Uni¬
versity in Altdorf, of the truth of his doctrine. Hofman, however, could
not bring himself to admit it. One letter from Harvey to Hofman is dated
Nuremberg, 20th May, 1636. Hofman raised objections on teleological
grounds. Harvey’s reply consisted of the argument that teleological diffi-

had emigrated to England and was resident in London at this time. Some of these phi¬
losophers resident in Oxford about 1648 formed an association there under the title of
The Philosophical Society. A close intercommunication was maintained between the
Oxford and London philosophers but ultimately the activity of the society was concentrated
in the London meetings.

‘The “ ereunetische oder zetetische Gesellschaft ” had the following aim: “Scopus
Collegii nostri unicus esto, veritatem e ratione et experientia turn inquirere turn inventam
commonstrare; sive artes et scientias omnes ratione et experientia subnixas a sophistica
vindicare, ad demonstrativam certitudinem reducere, dextra institutione propagare, denique
felici inventiorte augere.”

BRITISH AND GERMAN MEDICINE IN SEVENTEENTH CENTURY 227

culties should not prevent the drawing of conclusions from facts observed
at vivisections—whatever phenomenon we cannot explain, what its purpose
may be, should not prevent us from acknowledging that it does happen.

Among others besides Hofman, with whom Harvey corresponded on
scientific matters, were the Germans Paul Marquard Schlegel of Hamburg
and Daniel Horst. The polyhistor Hermann Conring, Schlegel and the
anatomist Werner Rolfink of Jena, partly on the strength of their own
experiments, espoused the cause of Harvey’s doctrine of the circulation
of the blood and adduced new arguments in their writings. The Viennese
anatomist Lorenz Wolfstriegel also showed himself by his Dissertation
(1658) to be an adherent of Harvey. Schlegel, in 1650, had produced his
commentary on the motion of the blood, in which he addressed himself
particularly to a refutation of Riolan, whose pupil he had been, and,
at the same time, shows himself so thoroughly at home in the general
question, that he was able to throw further confirmatory light on many
of its elements by new and ingenious experiments and considerations.
Harvey must have been pleased with Schlegel’s De sanguinis motu Cont-
mentarius, for he later sent the German author a copy of his own book on
Generation with an admiring letter, which has been preserved. Schlegel
mentioned that Hofman, who continued to be unconvinced, began to show
signs of yielding towards the end of his long life.

With the discovery of the circulation of the blood, the indispensable
anatomico-physiological basis for transfusion and for intravenous therapy
had been revealed. It is true that the earliest description of transfusion
had already appeared in a work published in 1615 by the famous German
chemist and physician Andreas Libavius (d. 1616), but this description
is so slight ® that it is doubtful whether the operation could be, or ever
was, carried out on the lines indicated. Experiments on infusion were
first undertaken in England by Christopher Wren (1657), followed by
Boyle and Qarke who, the last named especially, injected all kinds of
medicaments and fluids into the veins of animals. The first successfully
to practice transfusion in animals was Richard Lower (1666); he em¬
ployed direct transmission of the blood from the artery into the vein. The
first transfusion in man, with direct transmission of lamb’s blood, was
carried out in 1667 by Lower and Edmund King.

* Appendix necessaria syntagmatis arcanorum chymtcorum, Erjord, 1615: Adsit juvenis
robustus, sanus, sanguine spirituoso plenus\ adsit et exhaustus viribus, tenuis macilentus,
vix animum trahens. Magister artis habeat tubulos argenteos inter se congruentes; aperiat
arteriam robusti et tubulum inserat muniatque, max et aegroti arteriam findat, et tubulum
foemineum infigat, et jam duos tubulos sibi mutuo applicet, et ex sano sanguis arterialis
cdidus et spirituosus saliet, in aegrotum, unamque vitae fontem afferret, omnemque
langorem pellet.

228

MAX NEUBURGER

In Germany, the Leipzig professor Michael Ettmiiller who had made
a great study tour through Italy, France, England and the Netherlands,
published the results of his experiments in his Dissertatio de chirurgia
infusoria (Lipsiae, 1668). He had injected various drugs into the veins
of animals. He also relates how, as early as 1642, the huntsman of a
certain nobleman in Lausitz had rendered the hounds drunk by injecting
alcohol into their veins, and had administered medicaments in the same
way to sick dogs. In 1669 Joh. Sigmund Elsholtz, physician in ordinary
to the Great Elector, published his work Clysmata nova, in which he
discusses animal experiments on the infusion method, having apparently
no knowledge of other such experiments. Joh. Daniel Major, a Kiel pro¬
fessor, author of the works Chirurgia infusioria and Ortus et progress^
clysmaticae novae (1667) insists that the process was thought out by
himself. The Danzig physician Fabricius published the results of his ex¬
periments in 1666 in Philosophical Transactions, pp. 564 and 766. The
skillful military surgeon Mathaeus Gottfried Purman carried out trans¬
fusion on a leper at Goslar in 1668, and twice underwent the infusion of
drugs in his own person on account of scurvy. An English translation
of his Chirurgia infusoria (Francofurti, 1694) appeared in London in
1706.

The seventeenth century was the great age of specialized anatomical
research, and was notable for a long array of individual discoveries and
investigations, nearly every one of which had a physiological significance.
Besides the numerous discoveries of Qiarlton, Collins, Cowper, Glisson,
Highmore, Clopton Havers, Lower, Needham, Ridley, Tyson, Wharton,
Willis, there were the investigations of the Germans, memorable particu¬
larly for the anatomical achievements of the Swiss, J. C. Brunner and
J. C. Peyer (intestinal glands), and of Meibom (conjunctival glands),
Rivinus (sublingual gland), Wirsung (pancreatic duct), P. J. Schacher
(ganglion ophthalmicum). Brunner and Schacher had made study tours
through France, England and Holland. Conrad Victor Schneider, Pro¬
fessor at Wittenberg, overthrew the whole doctrine of the ancients with
regard to the numerous catarrhal diseases as the result of his extremely
careful investigations of the mucous membrane of the nose. He demon¬
strated anatomically and clinically that it was not the brain, but this
membrane, which secreted the mucus discharged in disease (De Catarrhis,
Wittenberg, 1660-62). Richard Lower developed the same theme in his
Dissertatio de origine catarrhi, in qua ostenditur ilium non provenire a
cerehro (in his Tractatus de corde, London edition of 1680, pp. 163-175).
This discovery localized catarrh in the air-passages and did away with

■

BRITISH AND GERMAN MEDICINE IN SEVENTEENTH CENTURY 229

the endless recipes for “ purging the brain.” Thomas Willis, who won
for himself great credit by his eminent investigations of the nervous
system, especially of the brain, advanced, moreover, our knowledge of
the blood-vessels over the brain, a subject also enriched by the .Swiss,
Joh. Jacob Wepfer. Worthy of recognition too is Elsholtz’s Anthropo-
totnia (Padua, 1657). One of the earliest anatomical atlases with super¬
imposed plates, a work of Johannes Rummelin of Ulm, Catoptrum micro-
cosmicum (1619) was published in English (London, 1675, 1702).^
There was also an English edition (1653)* of the Syntagma anatomicum
fmblicis dissectionibus in auditorum usum aptatum by the German Pro¬
fessor in Padua, Johann Vesling, a widely used text-book of which there
were many editions."

The physiology of respiration was entirely the work of English scientists,
Boyle, Hooke, Lower, Mayow. Important work in the physiology of
digestion was done by the Swiss physiologists, Peyer and Brunner. Johann
Conrad Brunner made experimental excisions of the spleen and pancreas
in the dog in 1683, keeping the animal alive, with normal digestion, for
some time after. In one of these excisions he found that the dog had
extreme thirst and polyuria, which would seem to be a picwieer experiment
on the internal secretions of the pancreas. A remarkable pioneer in physio¬
logic optics was the German Jesuit, Qiristoph Scheiner. In his Oculus
(Muhldorf, 1619) he gave an ingenious demonstration of how images
fall on the human retina and noticed the changes in curvature of the lens
during accommodation and refraction by the pin-hole test, which bears
his name. William Briggs described papilla of optic nerve (1636).

The most prominent German physiologist of this time was Johann Bohn
of Leipzig, who experimented upon the decapitated frog in an absolutely
modem spirit, declaring the reflex phenomena to be entirely material and
mechanical. As against the current view of a “ nerve juice,” Bohn, like

'A survey of the Microcosme; or the Anatomy of the Bodies of Man and IVoman.
Englished by John Ireton, corrected by Clopton Havers. The third edition, London, 1738.

*The anatomy of the body of man: wherein is exactly described every part thereof,
w the same manner as it is commonly shewed in publick anatomies . . . Published in
Latin . . . and English by Nich. Culpeper. Londoi\ 1653.

* John Evelyn records in his diary for the year 1646: “ Three days after this I took
my leave of Venice and went to Padoa. to be present at the famous Anatomic Lecture,
which is here celebrated with extraordinary apparatus, lasting almost a whole month.
During this time I saw a woman, a child and a man dissected with all the manual opera¬
tions of the chirurgeon on the human body. The one was performed by Cavalier Veslingius
and Dr. Jo. Athelsteinus Leonaenas, of whom I purchased those rare tables of Veines and
Nerves, and caused him to prepare a third of the Lungs, Liver and Nervi-sexti par, with
the Gastric Veines, which I sent to England, and afterwards presented to'the Royal
Society ...”

230

MAX NEUBURGER

Wepfer, associating himself with Newton’s view, developed the hypothesis
that a force emanating from the brain gives to the nerves an oscillating
motion similar to the vibrations of the ether, and so causes the phenomena
of movement. Bohn, who, before acquiring his Doctor’s degree, had made
a study tour through Germany, Denmark, Holland, England and France,
was an enthusiastic adherent of Harvey, and has the merit of having
demonstrated the great importance of experimental physiology. His ex¬
periments are based upon a thorough knowledge of physics and chemistry,
as the contents of his Circulus anatomico-physiologicus seu oeconomia
animalis (Leipzig, 1680) abundantly prove. In this work British litera¬
ture is represented by numerous quotations. Besides Harvey, Boyle and
Bacon, the following authors are named: Briggs, Charlton, Digby, Ent,
Glisson, Highmore, Lower, Mayow, Needham, Wharton and Willis.

Bohn referred to the distinction between the senses of touch and of
temperature. Robert Boyle’s tracts on taste and smell are the first mono¬
graphs in the history of physiological literature to be devoted to these
special senses. They were often reprinted: Mechanical Qualities (Taste
and Odours) 1675.

Boyle in his early days travelled about the continent for a period of
six years. During his wanderings he met with a young German named
Ambrose Hanckwitz, and finding him to be a congenial companion and
an enthusiast in the pursuit of science, brought him to London and made
him his assistant. Hanckwitz dropped his German patronymic and became
known as Ambrose Godfrey. In Boyle’s laboratory, originally established
for experimental purposes, phosphorus, which had been discovered in
1669 by Brand of Hamburg, was first isolated in England by Boyle’s head
chemist Bilger, and he instructed Godfrey in its preparation. From the
manufacture of this element Godfrey soon made his fortune. He then
determined to develop the commercial side of his business, and in 1680
he built a house in Southampton Street, Covent Garden, where, in associa¬
tion with Boyle, he started a practice as a chemist and apothecary. On
the death of Boyle he became the sole proprietor. Godfrey’s establishment
in Southampton Street was probably the first that might be described as a
chemist’s shop in London (The MSS. Recipe Book of Ambrose Godfrey,
1660-1741).

The first London Pharmacopoeia was published in 1618, having been
preceded by German city pharmacopoeias such as that of Valerius Cordus
(1540) and Libavius (1606). The Pharmacopoeia Londinensis was
translated into English in 1679 by the famous herbalist Nicholas Culpeper.
Other English Pharmacopoeias of the time were Salmon’s New London

BRITISH ANU GERMAN MEDICINE IN SEVENTEENTH CENTURY 231

Dispensatory (1678) and Skipton’s Pharmacopoeia Bateaua (1688), com¬
piled from prescriptions of William Bate. German pharmacopoeias worthy
of mention are those of Minderer (1621), Schroder (1641), Mynsicht
(1697). Schriider’s and Mynsicht’s works were translated into
English.**

Through many fundamental ideas and achievements, the influence of
British upon German physiology extends to a greater or lesser degree far
beyond the seventeenth century. The discovery of the circulation of the
blo(xl, above all, was of universal importance. The first to make any
advance u[K)n the results of Harvey’s researches in the field of embryology
were Caspar Friedrich Wolf in the eighteenth century and Carl Ernst
von Baer in the nineteenth century. Glisson’s creative idea of " irritability ”
as the basic property of living tissues is traceable in the history of physi¬
ology since Haller, and is still valid in pathology. To Thomas Willis is
due the credit of having inaugurated the ep<Kh of experimental physiology
of the brain, in the sense of the localisation of the cerebral functions.

The anatomical classification of the cerebral nerves which Willis intro¬
duced held the field up to the time of Sommerring. A special Dissertatio
de glandula pituilaria was written by Brunner (Heidelberg, 1668).

Willis accepted the cerebrum as the organ of thought but argued from
experimental lesions of the cerebellum that it is the centre of vitality, the
controller of the involuntary movements of the heart, lungs, stomach and
intestines. SjK-cial supjx)rters of Willis’s doctrine were Ridley among
Englishmen and Bohn and von Berger among Germans; Haller and his
pupils oppo.sed it. Willis’s works on nervous diseases and on hysteria are
esteemed for their many striking clinical pictures; he also described
general paralysis and the symptom-complex myasthenia gravis. Willis
discusses with particular appreciation the excellent anatomical investiga¬
tions of the C'ity Physician of Schaffhausen, Johann Jacob Wepfer,*' on
the haemorrhagic nature of aix)plexy and the process of cicatrization.*“

‘“Joh. Schroder. Pharmacopoca mcdico-chywica. The compleat chymical dispensatory,
in five books: treating of all sorts of metals, precious stones, and minerals, of all vegetables
and animals, and things that are taken from them . . . The like work nez’cr extant
before . . . Written in Latin and Englished by William Rowland. London. 1669.

** Hadrianus Mynsicht. Thesaurus et armamentarium medico chymiaim ; a treasury of
physick . . . Written originally in Latine. and faithfully rendered into English by John
Partridge, physician to his majesty. London, 1682.

*■ Wepfer. Obserz'ationes anatomicac ex cadaz'cribus eorum, quos sustulit apoplexia
ciini exercitatione de loco cjus adfecto {i6j8 u. d.)

‘“Willis. De anima brutorum E.rcrcitationes, Pars secunda. Cap. Vlll, Londini, i6j2,
p. 264: Morbi hujus Theoria perquam exacte a Clarissimo IVepfero tradi videtur;
namquc imprimis ad catisas cjus adco abstriisas, et latcntes certo cruendas, Historias sk'c

Title-page of Willis’ De Anima with autograph of Wepfer.

Cowrteny o/ “ The Wellcome HUtorical Medical Muiteuiii
(The Wellcome Foundation, Ltd.)”

232

BRITISH AND GERMAN MEDICINE IN SEVENTEENTH CENTURY 233

In Wepfer’s observationes de affectibus capitis the following British
medical authors are quoted: Glisson, Harvey, Clopton Havers, Lower,
Mayeme, Morton, Sydenham, Willis.

Willis suggested an inquiry into the changes which the drugs bring
about in the stomach, the blood and the different organs. This suggestion
was carried out by Wepfer,^^ who in conjunction with Brunner and
Harder performed many pharmacodynamic experiments upon animals.
Willis was the leading exponent of chemistry in England, but he con¬
siderably weakened the crude theory of chemical processes in the organism
and attributed a greater influence to the nervous system. He referred
mental disorders to disease of the brain. It was Felix Platter who before
his time had classified diseases of the mind as disturbances of function.

Robert Boyle’s “ most important medical writing The History of
Human Blood of Healthy Men may be said to mark the beginning of
physiological chemistry. Boyle’s observations were new and always
original. After considering colour, taste, odour, heat, inflammability,
specific gravity, etc., of blood as a whole, serum and corpuscles respec¬
tively, the book summarizes the physiological knowledge of the time.
Boyle’s Medicinal Experiments appeared also in German.^^

In Germany a Chair of Chemistry was founded in Marburg as early
as the beginning of the 17th century, and later the Universities of Witten¬
berg and Jena also became seats of this doctrine. The learned Wittenberg
Professor Daniel Sennert attempted to combine Galenism with Para-
celsism and encouraged the use of chemical preparations, in which he was

observationes anatomicas adducit, in cadaveribus plurintum, ab affectu hoc defunctorum
declarantur: in tribus nempe percullsis sh’e desideratis, sanguis extravasatus, aut hie, illic
in grumos majores convenerat, aut cerebri substantiam late sugillarat; in altero quodatn
serosa colluvies totum iyKt<pa\or et extus et intus inundarat.

'‘Wepfer, Cicutae aquaticae historia, Basel, 1679.

Robert Boyle was created “ Doctor of Physick ” at Oxford, 8th September, 1665.
To him medicine owes more than can be readily defined, so wide was his influence in
securing a proper physical and chemical basis for the study of the human body in health
and disease. He rendered a real service to the more scientific study of medicine by his
advocacy of the extended use of simple medicines in lieu of the elaborate mixtures then
in vogue. (Of the Reconcileableness of Specific Medicines to the Corpuscular Philosophy.
To which is annexed A Discourse about the Advantages of the use of Simple Medicines,
London, 1685.)

Human blood memoirs for the natural History of Human Blood, London, 1683/4,
1685, 1686.

" Medicinische Experiments: oder Hundert Zusammengetragene auserlesene Artsney-
Hittel . . . ausser Engl, ins Teutsche iibers. Leipzig, 1692. Another German edition in
F. Tolet’s Wohlerfahmer Stein-Artst.

“ Sennert, the German Galen, is quoted in Harvey’s Exercitationes de generatione
animalium (Exercit. 49) as a man of learning and a close observer of nature.

234

MAX NEUBURGER

followed by Minderer and Rolfink. Sennert, the reviver of atomism in
Germany, the author of excellent clinical monographs, was nevertheless
addicted to crass superstition, as his works clearly show. These were
translated into English.^* Specially zealous exponents of Qiemistry on
the lines of the doctrine of Sylvius, were the Leipzig Professor Michal
Ettmiiller, whose works also appeared in an English translation and
Georg Wolfgang Wedel. Johann Rudolf Glauber was easily one of the
greatest analytical chemists of his time, but he stands between the scientific
chemists, like Boyle and Mayow, and those who deliberately followed
Alchemy. His works appeared in English translation.*^

Traces of Boyle’s influence are discernible in one of the most emi¬
nent German physicians and chemists Friedrich Hoffmann, the creator
of a famous mechanico-dynamic system. Hoffmann, who made the
acquaintance of Boyle during his stay in England (1683), acquired
lasting reputation by his numerous analyses of mineral waters, using
Boyle’s chemical analysis by wet method. Hoffmann taught even how
mineral could be imitated artificially—an idea which Bacon first advanced.

The chemist and physician Georg Ernst Stahl, the founder of the
“ Animism,” in his general outlook of disease followed along the lines
laid down by Sydenham.

The English Hippocrates, the medicus in omne aevum nobilis, Sydenham
became the standard-bearer of progress in practical medicine, following
the Hippocratic method and art of healing. His remarkable work. The
Method of Treating Fevers (1666), appropriately dedicated to Robert
Boyle, may justly be regarded as one of the main foundations of modern
clinical medicine. The clinical reputation of Sydenham depends upon his
first-hand accounts of diseases, such as the malarial fevers of his time,
gout, scarletina, measles, broncho-pneumonia and pleuro-pneumonitis,
dysentery, chorea, and hysteria. The influence of Sydenham lasted unto
the middle of the nineteenth century and beyond it. As to German
medicine, the Vienna Medical School and the so-called School of
Natural History were outstanding manifestations of Sydenham’s influ-

The weapon-salves nudadie, London, 1637. Epitome institntionum medicarum dispn-
tationibus XVIII comprehensa, Engl., Lond., 1656- Mcdicinae practicae libri VI, Engl.,
London, 1679. Practicae medicinae libri. Practical physick. In Engl., by Nicholas
Culpeper and H. Care, Lond., 1679. The institutions or fundamentals of the whole art,
both of physick and chirurgery . . . made English by N. D. B. P., Lond., 1686. Epitome
institutionum medicinae et librorum de febribus, Eng. London, 1686.

Ettmullerus abridg’d; or a compleat system of the theory and practice of physic.
Trtuisl. from the last edition of the works of . . . London, 1699; 1703; 1712.

" The works of Glauber . . . Containing great variety of choice secrets, in medicine
and alchymy . . . Translated ... by Christopher Packe. London, 1689.

BRITISH AND GERMAN MEDICINE IN SEVENTEENTH CENTURY 235

ence. Sydenham’s Praxis Medica Experimentalis, sive Opuscula Universa
appeared in Germany (Lipsiae 1695; 1711. Opera Universa Medica,
Lipsiae, 1827). Translated into German: Medicinische Werke, Wien,
1786-7. Sdmtliche Werke, Leipzig, 1795, Leipzig, 1802.

Walter Harris, a follower of Sydenham, wrote a treatise on acute
diseases in infants remarkable for some provision of the doctrine of
acidosis {De Morbis Acutis Infantum, London, 1689). This treatise
appeared in German translation (Leipzig, 1691). In connection with
Sydenham’s work it deserves mention that a group of important mono¬
graphs were published by British and German physicians in the 17th
century.”

As regards surgery, England had in Richard Wiseman a leader whose
importance in that field might be compared with that of Pare in 16th
century France. He was the first to describe tuberculosis of the joints as
tumor albus; he employed primary amputation in gunshot wounds of the
joint, and mentioned the first case of external urethrotomy for stricture.
The leading German surgeon of the period was Fabry of Hilden. Besides
him Johann Schultes (called Scultetus) and M. C. Purmann are worthy
of mention. The former’s Armamentum chirurgicum (Ulm, 1653) gives
a good side-light on the operations of the time through its interesting plates
in illustration of surgery and surgical instruments; the latter acquired
great skill and courage through his rough-and-ready operations in the
field.**

Another important relic of the Thirty Years’ War is the Medicina
Militaris of Raimund Minderer (Augsburg, 1620).*®

” Felix Plater’s Praxia Medica contains the first attempt at a systematic classification
of diseases, and in 1614 he reported the first known case of death from hypertrophy of
the thymus Riand in an infant. The first accounts of unmist 2 ikable scarlatina are due to
Michael Doring and Daniel Sennert. Sennert wrote on scurvy, dysentery and fevers, and
Wolfgang Hofer wrote on cretinism. The guinea-worm was described by G. H. Welsch,
a physician of Augsburg. The first publication on child-bed fever in Germany, Historia
med. novum istum puerperarum morbum continens, qui ipsis Friesel dicitur (1655), was
made by the Professor in Leipzig, Gottfried Welsch, who had visited medical schools in
Italy, France, England and Holland. Besides these, the following monographs also deserve
mention: Roger Coke’s autopsy of typhoid fever, Glisson’s account of rickets, Morton’s
Phthisiologia. Sir John Floyer’s Treatise on Asthma (1698) gives a post-mortem of
pulmonary emphysema, and assigns as the cause of spasmodic asthma “ a contracture of
the muscular fibres of the bronchi.”

" The Chyrurgeotu store-house furnished with forty-three tables cut in brass . . .
Together with a hundred choise observations of famous cures performed, written by
Scultetus and faithfully Englished by E. B. London, 1674.

“ Purmann’s Chirurgia curiosa (Francofurti, 1694, London, 1706).

" Medicina militaris seu libellus castrensis or, a body of military medicines experimented,
Englished out of High-Dutch, London, 1674, 1686.

236

MAX NEUBURGER

One of the best handbooks of surgery was written in the early part of
the 17th century by Heinrich Petraeus, Professor of Anatomy and Surgery
at Marburg—the Encheiridion chirurgicum, Handbuchlein oder kurzer
Begriff der Wundartzney (Marburg 1617). The author had gathered his
experience in Italy, France, England and Holland. At the beginning of
the 18th century the works of Glandorp, city physician of Bremen, were
also published in an English translation. His Speculum chirurgicum, in
particular, contains interesting surgical records.**

A German translation of Sir Thomas Browne’s Religio Medici was
published in 1680, and republished in 1746. A German translation of his
Pseudodoxia Epidemica was published in 1680 by Christian Knorr
(Peganius).

“ It is in the seventeenth century,” says Castiglioni, ” that one can begin
to speak of a real international science in all civilized countries. This
collaboration of scientists became a decisive as well as a characteristic
feature. The relations between countries became intensified, the results
of discoveries were quickly spread abroad.”

** Opera omnia . . • antehac seorsim edita, nunc simul collecta et plurimum emendata ...
Londini, 1729.

MEDICAL MATTERS IN MARCO POLO’S DESCRIPTION
OF THE WORLD ♦

LEONARDO OLSCHKI

1. Orientalism in Medieval Medical Literature.

Geographical discoveries and medical experience are closely interrelated.
From remotest antiquity to our own time diseases as well as remedies
were imported from distant countries into the Western world. A history
of human intercourse in its connection with the development of medicine
would be an interesting monographic contribution to our knowledge of
the dark and bright aspects of our civilization. A medical geography of
this kind would not be justified merely by the quantity of the material
involved or by the extent of the task in time and space. There can be
little doubt about the fact that medical experience gained in an unfamiliar
environment or in unusual zones contributed decisively towards reducing
the gap which for centuries separated the theoretical from the empirical
field of medicine.

The case of syphilis—although exceptional—is typical also in this
respect. Connected from the first, and under different names, with the
greatest geographical discoveries of all times, this mysterious plague re¬
vealed the limits of the traditional medical science just as the exploration
of a new continent altered the age-old image of the world accepted by
scholarship and nautical tradition.^ That scourge which deeply affected
the relations between the sexes in an epoch of refined culture and brilliant
civilization soon became an object of scientific investigation, empirical
observation, moral meditation and didactic poetry.* In all these expres-

* Le Divisament du Monde is the title of Marco Polo’s book in the Franco-Italian
version published by L. Foscolo Benedetto (Marco Polo, 11 Milione, Firenze, 1928).
Marco Polo’s Description of the World is the title of the new edition variorum based on
Benedetto’s critical text, published together with the Latin version of the Zelada manu¬
script by A. C. Moule and P. Pelliot (2 Vols.), London, 1938. Quotations in the present
article follow the English translation of Col. Sir H. Yule, The Book of Ser Marco Polo,
3rd edition revised by H. Cordier (2 Vols. and 1 Vol. of Addenda by Cordier), London,
1926. (Tharignon’s edition and notes (Le Livre de Marco Polo, 3 Vols., Peking, 1924-28)
do not add very many details about Asiatic medicine of the thirteenth century.

' A new contribution to this controversial question has been offered recently by Samuel
E. Morison, Admiral of the Ocean Sea. A Life of Christopher Columbus (2 Vols.),
Boston, 1942.

*Cf. L. Baumgartner and J. F. Fulton, A Bibliography of the Poem Syphilis sive
Morbus Gallicus by G. Fracastoro of Verona, New Haven, Conn., 1935.

237

238

LEONARDO OLSCHKI

sions of a new and shocking medical experience its aspects and symptoms
remained associated with the conquest of a new world.

The medical geography of Asia has no such dramatic climaxes and
impressive episodes. The medieval expansion of ancient medicine by the
Moslems created a medical community which included the Islamic world
and the whole Christian commonwealth of nations. Avicenna, the Persian,
was an authoritative master in Paris and Padua, just as Galen, the Greek,
was a leading medical author in Cordoba and Bagdad. There are many
examples of the intimate fusion of the West and the East in the medical
field.*

One of its most consistent and less known expressions is handed down
in the popular treatises and vernacular encyclopedias of the thirteenth
century which represented the layman’s culture and the contemporary
opinions of the public at large. In this partly forgotten branch of litera¬
ture a certain intentional medical orientalism appears to be more definite
than in any scientific textbook or in the standard works of the higher
professional institutions. The very successful manual known as a Se-
cretum Secretorum so popular in Marco Polo’s day still bears in its Latin
version the mark of its oriental origin and style.* Likewise the famous
Book of Sidrach translated into several European languages ennobles its
poor tissue of eclectical instruction by palming itself off as the substance
of all oriental sagacity.* A beautiful manuscript, painted in Italy at the
end of the fourteenth century and preserved at Paris in the National
Library, of the Tacuinum Sanitatis shows an Arabic inscription which
attests its use in the Islamic Near East.*

Long before that time the general idea of human wisdom and of super¬
natural virtues was so intimately connected with the literary image of the
Orient that the authors of popular treatises and compilations on hygiene

* The most important publications on this subject are listed in Arturo Castiglioni’s
History of Medicine, New Yoric, 1942 (Bibliographical Appendix). On texts and
sources of Asiatic medicine and science cf. G. Sarton’s Introduction to the History of
Science, Vol. I and II. Baltimore, 1927-1931.

* Lynn Thorndike, A History of Magic and Experimental Science etc. Vol. II, New
York, 1923, p. 267-278. A careful digest of the Secretum, with introduction and notes by
Oi. V. Langlois, La connaissance de la nature et du monde au Moyen Age etc. Paris,
1927.

* Langlois, op. cit.

* The manuscript has been reproduced and described by Elena Berti-Toesca, Bergamo,
1938. There are, of course, many more examples of the interconnection between Western
and Oriental medicine in the Middle Ages (cf. H. Sigerist’s short survey in Medieval
Medicine in “ Studies in the History of Science,” Philadelphia, Pa. 1941, p. 43-54), Those
mentioned here represent some different and typical aspects in the field of popular medical
literature intended for the education and the entertainment of laymen.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION 239

and medicine liked to give their books a distinctive oriental touch and
color whose last vestiges are still to be found, today, in the exotic dress
and gestures of quacks and magicians in fairs and even in plays. But
during the Middle Ages the popular views on a wonder-working oriental^
medicine were supported on the one hand by literary traditions going back
mainly to legends and poems of ancient origin, and on the other hand by
actual commercial experience and interests. The fabulous image of the
medical wonders of the East was confirmed and kept alive by the belief
in the healing virtues of metals and precious stones supposed to “ grow ”
in the remotest parts of Asia.^

This opinion was justified by the fact that most of the superstitions
connected with stones, minerals and gems, as well as with herbs, drugs
and balms, had an oriental origin and spread from antiquity throughout
the Western world in many ways and at different epcKhs. The fables
handed down mainly by Pliny, Isidor of Seville, the treatises of the Pseudo-
Aristotle, and some Arabic authors were condensed and supplemented in
the medieval scholarly encyclopedias or in compilations and manuals of a
determined popular character. It is only against this traditional and
literary background that the first medical experiences of Western travelers
in Asia appear in the right light. Marco Polo’s Description of the World
was not intended for scholars but for laymen who already knew the
wonders of Asia from books which catered to their interest and under¬
standing.®

A poem held in as high esteem as Gossouin’s Image du Monde con¬
tributed extensively toward spreading and confirming the stories of the
medical wonders of Asia.® A reference book of the importance of the
Liber de Proprietatibus Rerum, compiled by Bartholomew the English¬
man in 1250, taught freshmen all over Europe the virtues of stones and
drugs imported from Ethiopia, India and the mysterious countries of
the East.^® Likewise Binmetto Latini’s famous Tresor never fails to
mention the distant and fabulous origin of plants and minerals whose
sanative properties had already been described in ancient Lapidaries and
Herbals.^‘

' For the sources of these doctrines and legends cf. the works of Thorndike and Sarton
mentioned above.

' It is well known that the scholarly reception of Marco Polo’s book was slow and
hesitating. On its influence on geography and cosmography cf. Col. Yule’s Introduction,
op. cit. I, 129-141.

*Cf. Langlois. op. cit.

On this standard work of natural history ci. Thorndike, op. cit. II, 405-435, and
G. Sarton, op. cit. II, 586-588.

'' Digest, sources and bibliographical notes in Langlois, op. cit.

240

LEONARDO OLSCHKI

This was the kind of natural history the French and Italian laymen
heard from the street singers in public squares or from the pulpits of their
churches. The merchants and shopkeepers in the adjacent markets liked
to confirm the exotic provenance of magic minerals like “ heliotrope ”
used against jaundice, of sapphires “ which prevent flatulence ” and the
twelve Biblical gems so praised for their different healing properties.”
Those traders were inclined to support the stories told about the fabulous
origin of the most appreciated aromatic and medical drugs. Speaking of
cannel and cassia, Bartholomew the Englishman says that all those fables
were invented by merchants in order “ to make things dear and of great
price.”

Nevertheless, long before the Florentine commercial agent Francesco
Balducci Pegolotti drew up, about 1340, the most complete list of items
imported from Asia into Italy everybody knew that many of the most
efficient spices and drugs were among the principal commodities of the
oriental trade with the West.‘® With some characteristic exceptions and
additions, which would be worth while studying, Pegolotti’s list mentions
the same medical herbs and plants already enumerated a century before by
Bartholomew and other authors after the best authorities in the fields of
medicine and natural history.'*

However, the scholarly and literary approach to the materia medica of
oriental origin and character was independent of the empirical and com¬
mercial interests of the traders and travelers. In listing gems, plants and
drugs, Pegolotti considered only the requirements of markets and cus¬
tomers, and probably ignored the use and efficacy of the single items.
People of that sort were not concerned with wonders but with prices,
even when the commodities came from fabulous Asia and might have
evoked the marvels of the East. Thus the travelers’ and traders’ own
opinion about the oriental medical supplies seems to have been more
realistic than that taught in contemporary popular literature and in some
standard works of medical science.

The first recorded traveler who set out to fabulous Asia with his head
full of wonders was a physician, Master Philip, of the household of Pope
Alexander the Third. The Pontiff sent him, in 1177, to the unknown

** On these gems cf. Hasting’s Dictionary of the Bible, Art. Stones (precious), and
Langlois’ essay on Philippe de Thaon in op. cit.

'* Cf. F. Balducci Pegolotti, La Pratica della Mercatura, ed. by A. Evans, Cambridge,
Mass. 1936. On the contemporary oriental trade cf. W. Heyd, Histoire du commerce d»
Levant an Moyen Age (2 Vols.), 2nd edit. Leipzig, 1923, and A. Schaube, Handels-
geschichte der romanischen Volker, Miinchen-Berlin, 1908.

** Pegolotti, op. cit. p. 293-297.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

241

lands of Prester John of India with a letter for the legendary sovereign
who, several years before, had tried to challenge the most powerful rulers
of Europe.** The Pope’s physician never returned from this adventurous
embassy. His more successful followers, who went as missionaries to the
court of the Tartar Khans in Mongolia, became acquainted with many
strange things but not with wonders.** Nor is there any evidence that
the Polo family was much concerned about the magic properties of the
gems and precious stones which they had made their main commercial
articles.**

When Marco’s father and uncle set out, in 1262, for their first crossing
of the continent, they carried with them a store of jewels collected in the
Levant for that purpose. Thirty-five years later they brought back to
Venice “ a great wealth in jewels and gold ” acquired during their stay
in China with Marco, from 1275 to 1292.** For these commercially
minded travelers the principal magic property of their precious stones was
to make money out of them or to invest their earnings safely. This
realistic and commercial point of view prevails also in Marco Polo’s
Description of the World in which the magic power of the gems is never
reported in connection with medical matters although many of the precious
stones allegedly provided with curative properties are frequently men¬
tioned in his book.** There is hardly a trace in it of that medical exoticism
of oriental origin and character generally connected with drugs and stones
in the medieval schoolbooks and in the vernacular treatises in verse and
prose.

When he left Venice at the age of seventeen our traveler knew nothing
about contemporary medical science. Nor had he much to tell his fellow-
coiuitrymen about oriental systems of medicine when he came back home
after twenty-five years of traveling in Asia by land and by sea. His book
contains only indiscriminate and occasional details about curative methods
and superstitions followed in Central Asia, in the Far East, India and
Persia. Chinese and Indian medicine were occult science even for the
natives of these countries, just as Arabic and Western medicine were for
the laymen of Europe. Everywhere in the Old World medicine was the

** Cf. the author’s little book on Marco Polo's Precursors, Baltimore, Md. 1943, p. 16
et seq.

Ibid. p. 31-70.

”/W</. p. 71-78.

" Yule, I. 31.

** The only example of the supernatural power of stones given by Marco Polo is con¬
tained in his fabulous description of Chipangu (Japan), where some warriors acquire
invulnerability by inserting a magic stone between the skin and flesh. Cf. Yule, II, 2S9.

242

LEONARDO OLSCHKI

substantiation of philosophical and religious doctrines. To become a
physician was a matter of initiation, not merely of instruction. Marco
Polo lacked both, although he did acquire a deep and extensive experience
of the Eastern world. But he never dared to venture into the secrets of
exotic doctrines or into their intellectual and religious background.

^ This peculiar attitude of a seasoned and intelligent traveler toward
theoretical interests and knowledge is illustrated by a characteristic
anecdote from Marco Polo’s biography. At an indeterminate date shortly
after his return to Venice, in 1295, he was called in by Petrus de Abano,
the famous physician and professor of medicine at the University of
Padua.*“ In his no less famous Conciliator Petrus gave a rather detailed
report of his conversation with Marco Polo and of the information obtained
from him about scientific questions concerning the East.^^ There is no
evidence in the whole passage that the discussion turned on oriental
medicine. Although Petrus is said to have been deeply interested in magic
and necromancy, there is no hint at the many examples of oriental exor¬
cisms mentioned by Marco Polo as characteristic expressions of Persian,
Tartar, Chinese, Tibetan and Indian life and religion. Instead, the Paduan
physician inquired about the antarctic sky as seen from Sumatra, the
island from which “ they export to us camphor, lign-aloe and brazil.”
Marco was able to confirm the professor’s opinion that—in spite of the
intense heat—the Equatorial regions and the antarctic hemisphere were
inhabited, adding that in the same island “ there are certain very great
rams with a very coarse and stiff wool just like the bristles of our pigs.”

This curious passage is more than a simple anecdote. Its documentary
value consists in the fact that it shows what kind of information an out¬
standing physician and philosopher wanted to obtain from an interview
with the greatest traveler of his time. He was evidently eager to get
from him a reliable and empirical confirmation of the habitability of the
southern hemisphere, a theory Petrus held in the face of contrary opinions
prevailing in his time and supported by noted authorities in the field of
natural philosophy. The question of the habitability of the southern
hemisphere —del mondo senza gente, as Dante called it—concerned the
Aristotelian theory of climates and zones which was considered funda¬
mental in medieval physiology and in the system of Western medicine.

With his pertinent answers to some matter-of-fact questions Marco
Polo gave the theory of Petrus of Abano all the support of his own ex¬
perience. The existence of human, animal and vegetable life in the tropic

*®On this author cf. Thorndike, op. cit. II, 870-947.

"The passage reported by Yule, Introduction, I, p. 119-120.

MEDICAL MATTERS IN MARCO POLO’S DESCRIPTION 243

zones was proved beyond any doubt by the man whom the great physician
describes as “ the most extensive traveler and the most diligent inquirer
I have ever known.” This man was also the first traveler who could
reveal to the Paduan professor the very origin of three of the basic drugs
imported by Mohammedan sailors and merchants exclusively from the
tropical regions of Asia into the Mediterranean basin: the purgative aloe,
the stimulant camphor and the highly praised oriental dye stuff that was
to give its name to one of the largest countries in the New World.

2. The First Empirical Insight into Medieval Asiatic Medicine.

The first insight into Asiatic medical practice had already been given
half a century before by the Franciscan friar William of Rubruck, the
most intelligent and versatile of all the missionaries who traveled in the
East before Marco Polo. The geographical experience of the French monk
is not comparable to that of the Venetian explorer. But his stay of more
than four months at Karakorum, the first capital of the Mongolian
Empire, and the sharpness of his inquisitive mind enabled him to reveal
more details on Asiatic medicine than all the medieval missionaries put
together.**

Friar William is already famous in the annals of medicine because of
his first mention of rhubarb, a plant and drug then unknown to the con¬
temporary medical authors but widely used in China, Tibet, Mongolia
and also in the Eastern borderlands of Europe. Half a century later Marco
Polo affirmed that rhubarb is found in great abundance over all the moun¬
tains of the Chinese province of Tangut “ where merchants come to buy
it and carry it thence all over the world.” *® The Venetian had a purely
commercial interest in that plant which had taken root in Mediterranean
markets as a new article in the oriental trade. But the Franciscan monk
reveals also the use made of it in the Mongolian capital by a strange
Christian personage who seems to have been held in high regard by the
emperor, Mangu Khan, and his court, especially on account of his healing
miracles.** He pretended to be an Armenian monk, Sergius by name,
and to have come from Jerusalem to Karakorum, following a divine in¬
spiration to baptize the emperor.**

“The Journey of William of Rubruk etc., transl. and edited by W. W. Rockhill,
London, Hakluyt Society, 1900. The original Latin text in P. A. van den Wyngaert’s
Sinica Franciscana, Vol. I, Quaracchi (Florence, Italy), 1929.

’•Yule. I. 217.

“Mangu Khan ruled the Mongolian Empire from 1250 to 1259. His brother Kubilai
Ijecame Great Khan of the Tartars in 1260 and established his residence in Peking.

244

LEONARDO OLSCHKI

This quack and adventurer performed his medical wonders by giving
all sick persons some chopped root of rhubarb mixed with water into
which he dipped a small cross. When “ their bowels were stirred up by
such a bitter draught ” the patients considered this movement in their
bodies something miraculous.^* Although Sergius had arrived at the
capital only a month ahead of Friar William, in 1254, he had already
ingratiated himself with the Emperor to such an extent that he was called
in cases of emergency when the physicians and diviners of the court were
at their wits’ end. Soon after the arrival of Friar William, Mangu Khan
entrusted to the Armenian monk the treatment of his second wife because
the Mongolian sorcerers could do nothing to save her from death.

Friar William who had never before heard of rhubarb thought that it
“ was something holy which the monk had brought from Jerusalem in the
Holy Land.” Therefore he advised the wonder-working rhubarb specialist
“ to make the potion with holy water as is done in the Church in Rome.”
The emperor’s wife drank this mixture of holy water and chopped rhu¬
barb, and washed her breast with it while Friar William, assisted by two
Nestorian priests and Sergius, “ read the Passion of the Lord according
to John.” When Mangu Khan heard that the lady was better, he sum¬
moned the monks and priests to his palace on the next day. By taking the
cross in his hand and looking at it he showed clearly that he attributed
the quick recovery of his second wife to the magic power of the cross
rather than to the medical action of the rhubarb. This reaction is under¬
standable because the Mongolian emperor certainly knew very well the
effect of a root so popular in the medical practice of Central and Eastern
Asia.

By this token he interpreted the Christian faith just as another and
very effective way of conjuring demons, to be preferred in some cases to
the charms and tricks of his Asiatic shamans and diviners. But our
Franciscan friar, after having thought the matter over, took a more
realistic view of the efficacy of a mixture of holy water and chopped root
of rhubarb. In fact it happened less than two months later that a French
goldsmith and engineer who worked for the emperor at Karakorum fell
grievously ill.^* As he was convalescing, the Armenian quack adminis¬
tered to him two bowls of his usual rhubarb potion which the patient drank
thinking it was holy water. It “ nearly killed him.” And this was too
much for the French missionary who saw his friend and fellowcountryman

** Rockhill, op. cit. p. 168, 181 etc.

*• Ibid. p. 192.

” Ibid. p. 216.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

245

in danger of his life. Since he was already suspicious of the ability and
good faith of the Armenian monk, Friar William decided to give him a
lesson. He said to him: “ Either go as an apostle doing real miracles by
the grace of the Word and the Holy Ghost, or act as a physician in
accordance with medical art. You give to men not in condition for it a
strong medical potion to drink, as if it were something holy; and in so
doing you would incur great shame should it become known among men.”
The significance of these stern and menacing words did not escape the sly
Armenian adventurer. He understood that his successful career as a
doctor was over, at least at the court of the Great Khan.

Friar William revealed by those words that he did not consider rhubarb
any more as “ something holy brought from Jerusalem in the Holy Land ”
that could be administered with holy water and made effective by reading
the Gospel. He was finally convinced that it was a remedy to be prescribed
by a physician according to the rules of medical art. As to Sergius, it
was evident now that he was neither a monk nor a physician. ” From
this time,” says Friar William, “ he began fearing me and warding him¬
self off from me.”

By making that clear distinction between healing miracles and medical
treatment the French friar was in advance of many of his contemporaries
who were not always able to draw the line between supernatural influence
and the rational treatment of disease. This clear attitude enabled the friar
to make pertinent and reliable observations even in the field of exotic
medicine of which he was able to give the first report to Western mis¬
sionaries and scholars. No wonder that Roger Bacon liked to discuss
with his experienced Franciscan confrere all the details of this straight¬
forward travel account, which became one source for the Opus Majus.^*

As to Friar William, even in dealing with Asiatic medicine, he never
again mixed up its magic and empirical aspects as observed during his
stay in the Mongolian capital. He devoted a chapter of his report to the
description of the incantations, sorcery and jugglery carried out by the
various representatives of Asiatic Shamanism, who were then gathered
at the court of the Grand Khan.^* He even gave some examples of their
abominable practices and of the medical superstitions of sorcerers and
diviners who cured sick persons by the extraction of stones, splinters,
worms supposed by Chinese, Mongols, Tibetans and other peoples of
Eastern and Northern Asia to be the cause of many diseases. But he
prudently distinguished from these devilish jugglers the honorable Chinese

’* Ibid. Introduction, p. xxxix.

**Ihxd. p. 242-247.

246

LEONARDO OLSCHKI

doctors, “ who know full well the virtues of herbs, and diagnose the pulse
very skillfully.” *® Since there were a great many of them at Karakorum
he could observe personally, as he says, that “ they do not use diuretics,
nor do they know anything about the urine.” This assertion is contra¬
dicted by other sources of the history of Chinese medicine.*^ But since
Friar William emphatically affirms that he knew this detail by personal
experience it must be supposed that the Chinese physicians practicing in
the Mongolian capital represented a special school of Chinese medieval
medicine which was not particularly interested “ in urinalibus ” as a
method of diagnosis and treatment.

These physicians lived in the Chinese quarter of the capital together
with the rest of the “ Cathayans,” praised by Friar William because of
their skill in all manner of crafts. This information proves that this
section of the City of Karakorum was built and arranged after the model
of the towns of China prop>er. In describing the great city of Kinsay,
Marco Polo reports that the physicians there, just as their modem
.American colleagues, occupied some streets reserved for them in a special
section of the town.®* It was situated near that of the astrologers “ who
are also teachers of reading and writing.” But Marco failed to give any
general statement about Chinese medical practice. Thus Friar William’s
few remarks on this subject represent the only authentic knowledge
available in Europe on this subject for more than three centuries.®* The
few details revealed by the friar only showed that the physicians of that
once fabulous nation had some basic methods of treatment similar to those
generally taught and practised by their Western colleagpies. They did not
fulfil wonders or use secret remedies but felt the pulse and prescribed

*® Ibid. p. 156. On Chinese diagnostic methods and treatises on the pulse cf. K. Chimin
Wong and Wu Lien Teh, History of Chinese Medicine, 2nd ed. Shanghai, 1936, and the
little book by E. H. Hume, The Chinese IVay in Medicine, Baltimore, Md. 1940. For
Chinese herbs, drugs etc. cf. B- E. Read, Chinese Medical Plants etc. in “ The Peking
Natural History Bulletin,” Peking 1936; besides the same author’s contributions on
Chinese Materia Medica (ibid. 1931) and his Compendium of Minerals and Stones used
in Chinese Medicine (ibid. 1936).

** Rockhill, op. cit. p. 156 n. 1, considers Friar William’s statement on urological matters
to be “ certainly wrong.” As a matter of fact, none of the books on the history of Chinese
medicine mentioned above (note 30) describe the methods of uroscopical diagnostics used
in the Chinese medical practice. No details of this kind are given by lisa Veith in her
recent article on Medicine in Eleventh Century (3hina in Bulletin of the History of
Medicine, Vol. XIV. 1943, p. 159-172.

“ Yule, II. 203.

’* The first reliable and detailed reports on Chinese medicine by Western travelers are
those of the Jesuit missionaries of the sixteenth century, especially P. Matteo Ricci,
Opere Storiche (2 Vols.) Macerata, 1911-1913.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION 247

herbs and drugs just like the doctors of the East. This was the first
realistic insight into oriental medicine obtained through the experience of
a reliable reporter. This keen and experienced contemporary of Roger
Bacon knew very well how to differentiate the rational systems of medicine
based on empirical knowledge or theoretical foundations from the practice
of sorcery, magic or superstition with which oriental medicine was
generally identified. His statements were so disenchanting that they seem
to have been forgotten very soon. In any case, they could not influence
the general opinion about the medical wonders of Asia ubiquitously praised
and described in the current literature of his day.

3. Medical Matters in Marco Polo's “Description of the World."

Marco Polo contributed but little to the knowledge of medieval Asiatic
medicine. His remarks on that subject are scanty, vague and incidental.
He seems to have paid little attention to the curative methods of the Far
last where he had spent seventeen of the twenty-five years of his travels
in Asia by land and sea. The different tricks of sorcerers, diviners and
shamans captivated his own curiosity and aroused the interest of his
readers much more than the scientific background and the empirical
routine of professional physicians in Persia, China and India. But in
traveling through those vast regions where a system of medical doctrines
and traditions existed side by side with the superstitions of quacks and
magicians he was able to pick up some typical aspects and curious details
which deserve to be closely scrutinized and commented upon. The results
of such an investigation may contribute to the history of medicine to the
same extent as they throw new light on the personality of Marco Polo.

In spite of the paucity of pertinent data there is enough evidence in his
book that he knew well how to distinguish the exorcisms of conjuring
shamans from the professional routine of Asiatic physicians. In his cir¬
cumstantial and reliable description of the court of the Great Khan Kubilai
he expressly mentioned the “ leeches ” among the officials, functionaries,
dignitaries, astrologers and “ philosophers ” who crowded the emperor’s
residence at Khanbalic—the actual Peiping—and his summer palace at
Shandu.®* The emperor’s personal attitude toward these physicians-
in-ordinary is illustrated by a characteristic episode of his long and
glorious life.®®

In his graphic description of Kubilai’s annual hunting expeditions

“ Yule, I. 391 and 40S.

** Kubilai died in 1294, two years after Marco Polo’s departure from his court.

248

LEONARDO OLSCHKI

Messer Marco relates that the emperor was troubled with gout.** Since
he was the son of a drunkard and an habitual tippler himself, all the arts
of his diviners and thaumaturgs were not able to cure an inveterate,
chronic and probably constitutional disease. In fact we gather from
Marco’s report that he had recourse to more rational and successful
expedients in order to protect himself from the attacks of his infirmity.
He simply made arrangements against the inclemency of the weather.
When he traveled he was carried upon four elephants in a portable chamber
made of timber, lined inside with plates of beaten gold, and outside with
lion’s skins, a material used for covering the imperial tents and made
water- and weather-proof by black, white and red stripes of an everlasting
coloring substance. For the rest, Kubilai was wont to wrap his limbs in
the finest and most costly furs in existence, like those sent to him, in 1267,
by the King of Corea. A contemp>orary Corean chronicle reveals that of
these skins boots were made for the swollen feet of the Khan. In 1292,
soon after the Polos had left the capital on their way back to Venice, the
King of Corea came to Peiping with a suite of sorcerers and Shaman
women to cure the Khan of a disease of the feet and hands. They began
to recite exorcisms, “ whilst Kubilai was laughing.” The mighty sovereign
of the greatest empire on earth had become skeptical about the efficacy of
those conjuring spells and tricks. But this circumstance does not imply
that he trusted much more the ability of his physicians. However it may
be, and in spite of his podagra and chiragra, he managed to reach the age
of eighty after an eventful reign of thirty-four years.

Although we know nothing about the “ leeches ” of the imperial court
mentioned by Marco Polo, we must suppose that they were foreigners,
just as most of Kubilai’s civilian fimctionaries were. The Chinese manda-
rinate refused to cooperate with the conqueror who was forced to avail
himself of the most cosmopolitan officialdom and of a band of adventurers
in order to keep the Chinese people in subjection and to administer his
huge empire. We know from Marco Polo himself that Cathay and Manzi,
that is North and South China, were in a continuous state of threatened
rebellion which was kept down only by a powerful army of Mongols,

*• Yule, I, 404 and note 5. The statement about Kubilai’s gout is reported only in the
version of Marco Polo’s text published in the second volume of G. B. Ramusio’s collection
of Navtgationi & Viaggi, Venice, 1559. This version contains many more medical details
than any other edition of Marco Polo’s text The passages are published in the notes of
Benedetto’s critical edition and in the English translations of Yule and Moule-Pelliot
It is probable that most of those passages had been intentionally suppressed or altered
by the medieval editors, copyists and translators because of the technical character of
these details.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

249

Alans and other Asiatic peoples led by Tartar “barons” and officers.
Kubilai would never have trusted a “ collaborationist ” Chinese physician,
if there had been any such inclined to accept the job. This may explain
the fact that the emperor chose a Nestorian Christian from the Near East
to be the head-master of astronomy and medicine at the imperial court ”
and asked the Pope, through the intercession of Marco’s father and uncle,
to send him as many as a hundred “ doctors ” of the Seven Arts for the
scientific and religious enlightenment of his country.®* In the same way
the “ enchanters and astrologers in his train ” were people from Tibet and
India, as Marco Polo reported in his description of the Khan’s palace.®*
Hence we must conclude that the “leeches” of his court were either
Nestorian Christians, as were so many of his officials, or Saracens, who
liad a strong influence in all kinds of affairs in spite of the emperor’s
dislike of Islam.*® By that Kubilai Khan only continued a tradition going
back to his predecessor Kuyuk Khan who already appointed a European
physician, Isaiah by name, probably one of those wandering Jewish doctors
forced by increasing persecutions to hunt for fortune in distant lands.*^

Since the cultural and religious centers of the Nestorians and Mohamme¬
dans were situated in Bagdad, Bokhara and the Near East, it is more than
probable that some practices and doctrines of Greco-Arabian medicine
could have been introduced into Tartar-dominated China in Marco Polo’s
epoch by the foreign physicians of the court. It is admissible that, to a
certain extent, an ecumenical connection might have existed in the medical
field during the cosmopolitan Yuan dynasty and that Kubilai’s doctors,
both Christian and Saracen, drew their medical rudiments from the same
sources and traditions which dominated the schools of Western Asia and
flourished in the centers of European medical education.

How far the indigenous Chinese medicine had been influenced by doc¬
trines and methods of Greek and Arabic origin can be established only by
an historian who is a specialist in both fields.** But we owe to Marco
Polo the knowledge of the most important center of China’s medical

' " Cf. A. C. Moule, Christians in China etc London, 1930, p. 228 et seq.

” Yule, I, 13.

••Ibid. 301.

•* Ibid. 422 and n. 5.

“ Cf. K. Chiming Wong and Wu Lien Teh, op. cit. p. 261. Kuyuk Khan reigned for
only two years, from 1246 to 1248. Friar Oderic of Pordencme affirms in his Relatio
(Sinica Franciscana I, 475) that during his stay in Peking, in the twenties of the
fourteenth century, the emperor had four hundred indigenous physicians, moreover eight
Christians and one Saracea

“The contributions in the single fields of Chinese medicine are listed in H. Cordier’s
Bibliotheca Sinica (4 Vols.) 2nd edit. Paris, 1904-1908, with a Supplement, 1922.

250

LEONARDO OLSCHKI

culture, situated, as he says, in “the noble City of Suju,” the actual
Su-Chau in the Kiang-nan province of Southern China, a city where he
found “many philosophers and leeches, diligent students of nature.””
His statements that “in the mountains belonging to this city, rhubarb
and ginger grow in great abundance ” is certainly erroneous. But the few
words devoted to the intellectual life of Su-Chau are quite sufficient to
reveal that the same connection of philosophy with medicine and natural
science characteristic of contemporary European medical art and education
existed in China also, in spite of the fundamental difference of the doctrines,
conceptions, methods and traditions.

These scientifically educated physicians of the Far East furnished to
Marco Polo a criterion for judging the standard of civilization attained
by a region he visited and described. He characterized the backwardness
and ignorance of the tribes living in the distant province of Yun-nan by
the fact that “ there is never a leech; but when any one is ill they send for
their magicians, that is to say the devil-conjurers and those who are the
keepers of the idols.” ** By the extensive and detailed descriptions of the
exorcisms, ceremonies, dances, sacrifices and spells used on such occasions
by these tribes, it is easy to recognize that they still preserved their
indigenous rites and magical incantations. The practices of these medicine¬
men were much like those of the Tibetan Lamas, but entirely independent
of the ways and beliefs of their Chinese neighbors.

It is known that at the ep)och of the Chou dynasty—in 1140 B, C.—
the functions of sorcerers and that of doctors were officially separated.”
Only approved physicians were entitled to collect herbs for medical pur¬
poses and to handle matters relating to medicine as a craft and science.
The high standard reached by medicine in the most civilized places of the
country is represented by the many hospitals of Quinsay “founded by
ancient kings, and endowed with great revenues,” where the poor cripples
unable to work for their livelihood were interned and, if they were capable
of work, made to take up some trade.** There is certainly a great deal of
oriental over-estimation in Marco Polo’s report that in the same city of
Quinsay there were a thousand springs and hot baths “ large enough for
one hundred persons to bathe in together,” But it is probable that in
important places like this public hygiene was considerably developed.

” Yule, II, 181.

“ Ibid. 86.

** K. Chiming' Wong and Wu Lien Teh, op. cit. p. 13. Cf. also C. Kendall, Magic
Herbs: The Story of Chinese Medicine, 1932.

” Yule, II, 188.

” Ibid. 189.

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION 251

In Khanbalic, for instance, “the city is preserved in a better and more
healthy state” by the prohibition against burying or burning any dead
body within its walls/* The dead, as well as the prostitutes, were confined
to the suburbs and to places assigned for their purposes.

There is, in fact, no hint at epidemics and plagues in Marco Polo’s
reports on Asia, but this reticence does not imply that official measures
of sanitation taken by Chinese or Mongolian authorities and described
by our traveler were sufficient to prevent the epidemical spreading of some
typical Asiatic diseases. Marco Polo probably refused to cast a gloom over
the colorful and spectacular image of the Asiatic continent and its peoples.
He seems to have been reluctant to enter into medical details, even when
he had a direct experience of sick persons and diseases. For instance, he
did not tell what caused most of his six hundred fellow-travelers to die
during the two years journeying that brought the Polo family and the
Princess Cocachin from Cathay to the shores of Persia.**

Since there is no hint at any shipwreck suffered by the Chinese fleet
during this long navigation, it is probable that the passengers and the
crew had been decimated by tropical diseases, scurvy and malnutrition.
But Marco failed to mention the circumstances of that disastrous journey.
Likewise he described extensively the complicated tricks by which the
conjurers and devil-dancers of the Far East expel the evil spirits from
the body of a sick man, but he did not tell anything about the diagnostic
or healing practices of surgeons and physicians. This striking omission
may be explained easily by the fact that Marco took little interest in
Chinese civilization and every-day life and preferred to report on the
attractive and exceptional aspects of the Far East. On the other hand,
the Chinese themselves never liked to give any insight into their home-life
or traditions to the “ bearded ” foreigners scattered throughout the country
by the Mongolian administration. Furthermore by an act of honesty, and
following the general trends of medieval Western education, Marco Polo
never entered into the hallowed precincts of science and professional
activities. As a layman, he had a marked curiosity for the strange and
popular types of medicine whenever he discovered them among the tribes
of Asia.

Thus when contrary winds forced him to spend five months at Sumatra
on his homeward passage he observed that the islanders extracted from
the branch of a tree a certain wine “ of such surpassing virtue that it cures
dropsy, tisick and spleen.” This wine probably had the same exhilirating
properties as a drink made from palm-sugar by the people of Quilon in

‘•/Wd. I, 414.

*• Ibid. 35.

Ibid. II, 292.

252

LEONARDO OLSCHKI

Southern India.®^ It might have had the effect of a palliative against the
paroxysmal attacks of the diseases mentioned by Marco Polo. He also
had the opportunity of observing some curious details characteristic of
popular medicine in continental India. During his stay in Madras, he
visited the famous tomb of St. Thomas the Apostle, at Mailapur, where
he learned that the Christian pilgrims used the earth from the place where
the saint met his death to cure a quartan or tertian fever, a disease probably
endemic in that part of India. In the “ noble city of Cail ” on the southern
tip of the same province of Maabar our traveler noticed for the first time
a custom common to all India and supposed “to be very good for the
health.” ®* “ People there continually chew a certain leaf called Tembul
which the lords and gentlefolks have prepared with camphor and other
aromatic spices, and also mixt with quicklime.”®* Just as our much
advertised chewing-gum, that leaf and this mixture stimulated the glands
of the oral cavity and caused “ spitting out the saliva that it excites.”
Marco Polo seems to have been convinced of the salubrious efficacy of
this practice, although ’le attributed the latter mainly to the pleasure
“of gratifying a certain habit and desire.” He ascribed the “capital
teeth ” which greatly improved the appearance of the Brahmans to their
chewing of that invigorating herb.

Our Venetian traveler had some opportunity of delving into the secrets
of Indian medicine. In Quilon he was informed of the “ good astrologers
and physicians ” practising in that famous seaport, where the staple trade
from Arabia, the Levant and China flourished for centuries.®* Here he
could have found again the Moslem system of medicine going back to
Greco-Arabian texts, traditions and doctrines and followed, as in the Far
East, almost exclusively by the Mohammedan doctors and practitioners.
The Hindus used a different and less scientific empirical system, based on
religious beliefs, ancient superstitions and magical alchemy. It is of this
latter that Marco Polo obtained positive and remarkably reliable knowledge.

In his description of India he was especially interested in the ways of
Brahmans and Yogis. The abundance and nature of the details concerning
these leading castes is not explained alone by their importance in Indian
life and civilization. The legend and romance of Alexander the Great had
already made the Brahmans popular everywhere in Eurof)e, as a strange
people with queer habits and beliefs.®® As in many other cases, Marco

“ Ibid. 376. “ Ibid. 371.

“ Ibid. 354. “ Ibid. 354.

Dindimi De Vita Bragmanorum in “ Kleine Texte zum Alexanderroman,” ed. by
Pfister, 1910, p. 6-9. Marco Polo probably knew something about the Brahmans from the

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

253

Polo’s interest in the natural and human aspects of India is inspired or
influenced tales and fables of literary origin and character.®* Since
antiquity and throughout the Middle Ages the alleged longevity of the
Brahmans is mentioned among the singularities of India’s wonderland.®^
The medical background of this fable is perhaps to be found in the Hindu
conception of medicine as the art of longevity, as taught in the Ayurvedic
system said to have been directly inspired by Brahma himself.®* However
it may be, Marco Polo did not attribute the alleged longevity of the
Brahmans to the magic power of precious stones, spells, beverages or to
the fabulous fountain of youth, but simply and realistically “to their
extreme abstinence in eating.” ®* This statement fits in with the leading
jwsition held in Indian medicine by dietetics.*® On the other hand, his
report that the Brahmans “ never allow themselves to be let blood in any
part of the body” seems to be incorrect, since phlebotomic surgery and
application of sanguisuges were widely used in Indian medical practice.*^
As to Yogis, they were described by Marco Polo as a special class of
people and “ such cruel and perfidious idolaters that it is very devilry.” **
They are reported to be extremely long-lived, “ every man of them living
to a hundred fifty or two hundred years.”*® In order to achieve such
exceptional longevity, they use a potion of sulphur and quicksilver mixed
together which they take twice every month from childhood.

In this particular case we find again in a short and simple statement an
almost inextricable entanglement of fabulous reminiscences and authentic

oriental versions of the legends of Alexander the Great going back to the romance of the
Pseudo-Callisthenes, a Greek text of the fourth century A. D.

“ The legends of Alexander the Great were especially popular in Mcrfiammedan Asia
where they are still alive. Cf. the author’s botJe on Marco Polo’s Precursors, p. 9-15.

" Cf. the Commonitorium Palladii (Pfister, op. cit. p. 2) where the Brahmans are told
to live “ per centum quinquaginta annos propter aerem bene temperatum et domini
voluntatem.”

“Cf. J. Jolly, Medizin in the “ Grundriss der Indo-Arischen Philologie und Altertums-
kunde,” Strassburg. 1901, p. 12. and the passages relative to the matter in the German
edition of Vdgbhala’s A^iingahrdayasarnhiti by L. Hilgenberg and W. Kirfel, Leiden,
1941, the most complete Indian medical text accessible so far in a modern language.

" Yule, II, 365.

*“ Jolly, op. cit. p. 36-39. “ The Physician and his Concept of Dietetics ” was a part
of a course of lectures on Hindu Medicine delivered, in November 1940. at the Institute
of the History of Medicine of the Johns Hopkins University by the unforgettable Dr.
Heinrich Zimmer, whose premature passing, in March 1943, deprived his friends and
pupils, as well as indology, of a most stimulating and exceptionally versatile scholar and
master. The course will be published as Vol. V of the Hideyo Noguchi series.

" Jolly, op. cit. p. 30 et seg. and the text mentioned above note 58.

“Yule, II. 366.

** Cf. the passage of the Commonitorium Palladii quoted above n. 57.

254

LEONARDO OLSCHKI

positive facts. The potion of sulphur and quicksilver is by no means a
wonder working elixir of life but simply an imaginary mixture of the two
basic elements of the Ayurvedic pharmacopia, still used in the modem
system of Hindu medicine.®* The fame of those fundamental ingredients
extended throughout the Asiatic continent where the miracles performed
by the Yogis were as well known as the fables told about their wonder
working medical alchemy. When Marco Polo arrived in Persia, a year
later, with the presumptive bride of Arghun Khan, only to find that this
jiowerful potentate was dead, he probably heard that Arghun had been a
victim of a mixture of sulphur and mercury, recommended to him by
Indian Bakhshis as an Elixir of Longevity.®® This story, and court gossip
of this kind, perhaps started by rival physicians, only confirms the reputa¬
tion of the Ayurvedic pharmacopia in the Tartar-ruled countries of Asia.
Marco Polo probably knew something about it before coming to India,
just as he was already prepared by the legends of the cycle of Alexander
the Great to cast an eye on the dietetic rules of the Brahmans and Yogis.**

Marco himself seems to have been especially concerned with the relation
between food and health. During his stay at Hormus, the great seaport
at the entrance to the Persian Gulf, he noticed that the people there
“ never eat meat and leaven bread except when they are ill, because if they
take such food when they are in health it makes them ill.”®^ The diet
they follow “ in order to preserve their health consists of dates and salt
fish,” a fact repeatedly confirmed by Arab and European travelers of the
Middle Ages. In this case Marco Polo deals with ordinary people whose
dietetic habits are not dictated by religious scruples or pagan superstitions
but only by climatic and sanitary precautions. There can be no doubt
that his own sober and prudent mode of life contributed, in great measure,
towards keeping him healthy and vigorous amid the strain, dangers and
unusual exertions of twenty-five years of exhausting travels through
different zones, the remotest lands, and among strange peoples.

We know of only one illness suffered by our traveler during so many
years full of both hardships and pleasant adventures. It must have been a
very serious one because he was detained for a whole year in Badakhshan,
the mountainous country of Central Asia, which he reached on his first

** Jolly, op. cit. p. 3, 25 and passim, and Yule’s note to this passage of Marco Polo’s te.xt.

" Yule. II. 369 n. 5.

** “ Nullam aliam annonam ad manducandum querimus, nisi quam mater terra producit
sine aliquo labore- De talibus cibis implemus mensas nostras, qui nobis non nocent, et
proinde sumus sine aliqua egritudine, et dum vivimus sani sumus. Nullam medicinam
nobis facimus etc.” Letter of Dindimus to Ale.xander the Great, Pfister, op. cit. p. 11.

" Yule, I, 107.

]

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

255

crossing of the continent in 1273.** There are no hints at the nature of
this long illness in his detailed description of that province, nor did Marco
reveal the treatment to which he had been subjected by the local physicians.
But he tells us that he owed his recovery to the pure air of the lofty
mountains he was advised to visit and where he found “an extensive
plain, with great abundance of grass and trees and copious springs of pure
water running down through rcKks and ravines.” A stay of two or three
(lays, he says, in that lovely country was sufficient to cure “ any kind of
fever or other ailment that may hap ” in the towns, valleys and plains of
the vast province of Badakhshan.®*

This experience made our traveler sensitive to climatic impressions and
prompted him to report, at one time, about the fine temperate clime of
Kashmirand at another time about the unhealthy climate prevailing in
summertime in the almost inaccessible Chinese border province of Western
Yunnan.At Hormuz he found the heat utterly unbearable with some
relief obtained by the use of wind-catchers built on the top of the houses.''*
These climatological data are infrequent and isolated but remarkable
enough, since no other details of that kind are to be found in medieval
travel literature, especially in connection with problems of health. The
relation between endemic diseases and the natural conditions of human
life did not escape his experienced sagacity. In Yarkand, one of the
principal centers of Chinese Turkestan, he noticed that a large proportion
of the inhabitants had “ swollen legs, and grops at the throat.” ** These
are indubitable symptoms of the goitre still raging in the same region and
which Marco Polo attributed to “ some quality in their drinking water.”

But our traveler is much more interested in remedies than in diseases.
This explains the rarity of his pathological remarks which, however, is
compensated for by his allusions to local medical habits and singularities.
Even in these cases he has some preferences upon which the selection and
description of facts seems to depend. He has a marked interest in balne-
ology, a very popular division of medicine during the Middle Ages
although — or perhaps — because it was not always appreciated by pro¬
fessional physicians. Owing to this, Marco Polo is the first and only
author who ever mentioned what he called “ the best baths from natural
springs that are anywhere to be found,” situated in the city of Erzinijan

"Marco’s illness is mentioned only in Ramusio’s version (Yule, I, 158) and in the
Zelada manuscript published by Moule-Pelliot, Vol. II, p. xvi.

" The Zelada-version (_loc. cit.) adds that “ there are also two or three mountains as
it were sulphurous, and the waters always come sulphurous from the mountains.”

"Yule. II. 166. ''Ibid. 452.

”/6td. 86. ’’•Ibid.l.W.

256

LEONARDO OLSCHKI

in the Armenian province of Erzerum/* On the route from Hormuz to
Kerman in Southern Persia he noticed many natural hot baths which
“ have excellent virtues; they cure the itch and several other diseases.” ”
Thus he was very impressed by the fact that all over the country of Cathay
“ every one has a bath at least three times a week, and in winter if possible
every day, whilst every nobleman and man of wealth has a private bath
of his own use.” It is only the abundance of coal (those ” black stones
existing in beds in the mountains”) that made this national custom of
China possible. The abundance of fuel allowed the city of Quinsay to have
the huge hot baths for the health and delight of all the inhabitants.”

Marco Polo’s interest in remedies and specifics caused him to pay respect
to the Asiatic materia medica. In accordance with the superior importance
of purgatives in medieval medicine his remarks on this subject are par¬
ticularly pertinent and sometimes based on personal experience. This is
the case with a wine of dates mixed with spices, used in the region of
Hormuz and which he found very good.’* It first causes repeated and
violent purging, but afterwards works as a fattening restorative. This
spirit distilled from dates is said to have been mentioned by Dioscorides
and still to be used as a medicinal stomachic.’*

A much less palatable purgative he found at another time on the desert
route from Kerman to Yedz in Eastern Persia. What little water one
does meet in that dreary country is a bitter green stuff of which no one
dares to make use “ because of the excessive purging which it occasions.” '*
But Marco failed to reveal whether this water and salt was used in appro¬
priate doses in the medical practice of the region. Yet he had to tell a story
about the way the pirates of Gozurat, a kingdom on the West Coast of
India, employ “a stuff called Tamarindi”^^ They transform this mild
laxative into a violent purging potion by mixing it with sea water and
force the merchants to gulp it down in order to secure the valuable stones
and pearls they might have swallowed when in danger of losing them.

But one of Marco’s most direct contributions to our knowledge of the
Asiatic pharmacopoeia concerns ophthalmology. When he traveled between
Kerman and Yezd in Eastern Persia he learned that the brass-foundaries
near Kubinan prepare “ Tutia, a thing very good for the eyes.” ** It was
collected from an iron grating situated on top of a great flaming furnace
where the ores were melted. Hence it follows that the crude oxide of zinc

Ibid. 45.

"Ibid. no.

"Ibid. 442.
"Ibid. II. 189.
” Ibid, I. 107.

” Cf. Yule’s remarks to this passage, ibid. p. 115.
"Ibid. 123.

•* Ibid. II. 392.

"Ibid. I. 125.

MEDICAL MATTERS IN MARCO POLO’S DESCRIPTION 257

called “Tutia” in medieval Persian and “tutty” in mcxlern English
metallo-chemistry then served to prepare a collyrium or an eye-ointment
used in different parts of Asia. In fact our traveler noticed the same
“tutia,” many years later, in the Indian seaport of Cambay, among the
commodities brought there by merchants “ in many ships and cargoes.”**
The same oxide of zinc was known in antiquity under the name of
Pompholyx and mentioned by Galen as an ingredient in salves for eye
discharges and pustules.** It is possible that its production and use in
Persia and India was connected with the medical traditions of antiquity,
handed down by oriental authors of Mohammedan faith and education.

A similar conformity between some aspects of Western and Asiatic
medicine is attested by the use of the gall of the crocodile, which is
recounted by leading authorities as an unsurpassed remedy against pustules
and the like affecting the eyes. Traveling in the almost inaccessible Chinese
province of Carajan, near the borders of Burma, Marco saw those ” great
serpents ... so hideous that the very account of them must excite the
wonder of those to hear it.” ** After killing them by means of a compli¬
cated contrivance the natives ” proceed to extract the gall from the inside,
and this sells at a great price; for you must know it furnishes the material
for a most precious medicine.” It was used in the Far East against the
bite of mad dogs, as obstetrical stimulant and, in small quantity, for curing
the itch and even the worst diseases of the skin. No wonder that a remedy
of this kind “ sells at a high price.”

Of more local interest are the woollen girdles knitted by the monks of
the famous Jacobite monastery of St. Barsamo, or Barsauma, on the
borders of the territory of Tauris near the Persian frontier with Great
Armenia.** The monks placed the girdles before the Saint’s altar during
the service, “and when they go begging about the province . . . they
present them to their friends and to the gentlefolk, for they are excellent
things to remove bodily pain.” From a medical standpoint, which in this
case corresponds with that of the Roman Church, the healing power of
the girdles cannot be ascribed to the influence of that heretical saint. It
must be remembered that the people living in that dreary country of
mountains and deserts deeply appreciated those warming garments which
relieved them from colics or rheumatic aches.

“Ibid. II, 398. This remark about the export of tuiia into India only in the Ramusio
version (cf. above, n. 36).

“Yule, II, 398, note. For the production and medicinal use of oxide of zinc in old
China cf. B. £. Read, A Compendium of Minerals and Stones used in Chinese Medicine
etc., Peking, 1936, No. 59.

258

LEONARDO OLSCHKI

Marco Polo’s main interest in the materia medica concerns, of course,
medical as well as aromatic drugs. They represent one of the principal
commodities of the oriental trade and our traveler never forgot that he
belonged to a family of merchants. Wherever he noticed the presence of
drugs and spices in Asiatic places or markets he never failed to give
suitable information on them. Thus we know the centers of continental
and insular Asia where rhubarb, ginger, lignaloes, pepper, camphor, cassia,
cinnamon and saffron were produced and exported. Through his complete
description the West obtained the first authentic report about the origin
of musk, so deeply appreciated in medieval medicine and a basic ingredient
of many perfumes.*^ Our traveler had certainly the presentment that none
of his fellow-countrymen could believe that a precious stuff like this was
extracted from a sac under the skin of the abdomen of the male musk deer.
For that reason he “brought the dried head and feet of one of those
animals to Venice with him,” as a disenchanting document of the true
origin of all the legendary perfumes of Arabia.

However Marco Polo never mentioned the medical properties of the
drugs he had encountered. He probably knew very little in that field and
certainly thought that this subject matter was no business of the general
public for which his book had been written. The extensive list of oriental
drugs and spices composed about 1340 by the Florentine commercial
agent Francesco Balducci Pegolotti does not contain any remarks about
their use in medical practice.®* Even the pharmacists of the fifteenth
century, who were sent to India and China to collect information con¬
cerning the drugs of the Eastern world sometimes confined themselves
to simply enumerating those with which they had become acquainted.**
All these travelers and authors were entitled to believe that professional
experts in medicine and “ simples ” did not need technical explanations
about the use of drugs and herbs. Marco Polo limits his task even further
by declining to report pn Asiatic spices “ which never reach our
countries.”*® This may be the reason why he never made any allusion
to tea and the use made of it by the peoples of the Far East. This strange
omission has stirred up many speculations concerning his reliability and
capacity for observation.®^ He could not find any reason for entertaining

Ibid. I. 275 and note; II. 34. 45. 54.

•* Cf. above note 14.

**Cf. Harry Friedenwald, The Medical Pioneers in the East Indies, in Bulletin of the
History of Medicine, Vol. IX (1941), p. 487-504.

” Yule, II, 56.

" “ A tree with leaves like laurel but longer and narrower, and with a small white
flower like the clove ” found by Marco in the mountains of the Province of Candu, in

MEDICAL MATTERS IN MARCO POLO’s DESCRIPTION

259

his readers with the story of an exotic infusion which he probably did not
like as much as he did the different wines of rice, fruits and spices he
tasted all over Asia. Marco Polo’s reticence is the first symptom of the
well known fact that tea never became popular in Italy or elsewhere in
the Mediterranean countries.

Yet he did not omit to mention other Asiatic drugs when he was able
to connect them with some stories of an edifying or attractive character,
independent of his own medical and commercial interests. It is the strange
tale of the Old Man of the Mountain and of his fanatical “ Ashishin ” —
so popular in the whole Mediterranean area — that caused him to make
his countrymen acquainted with hashish, administered in the form of an
intoxicating potion by the powerful leader of the Ismailits in order to
make the young adherents of his sect ready to carry out his political
crimes.”

In striking contrast to that gruesome Mohammedan story he related
the charming Christian legend about myrrh, connected with the tale of
the Magi, as told to him by the fire-worshippers in the Persian village of
Gala Hafenstan.®* “They relate,’’ he reports, “that in old times three
kings of that country went away to worship a Prophet that was born,
and they carried with them three kinds of offerings; gold, and frankin¬
cense, and myrrh; in order to ascertain whether that Prophet were God,
or an earthly King, or a Physician. For, said they, if he take the gold,
then he is an earthly King; if he take the incense, he is God; if he take
the myrrh, he is a Physician ...” When they saw that the Child had
accepted all three, “ they said within themselves that he was the true God,
and the true King, and the true Physician.” This is the subtle and lovely
oriental way in which a tonic and antispasmodic drug became the symbol
of earthly medicine and of eternal salvation. In the interest of human
welfare, Marco Polo was always concerned with both.

Southern China, has been identified with the Assam-tea (Yule, II, 56 and note). Yule
(he. cit.) supposed the clove to be cassia buds instead of tea.

“Yule, I, 140 et seq.

Ibid. 78 et seq.

MEDIDAS DE SEGURIDAD CONTRA LA FIEBRE AMARILU
DURANTE EL VIRREYNATO DEL PERU

CARLOS ENRIQUE PAZ SOLDAN

Alla, en el comienzo del siglo XIX, precisamente por los anos de 1800
a 1804, padecio Espana, gravemente, una epidemia de fiebre amarilla,
importada seguramente por los barcos que venian de sus posesiones ultra¬
marinas, de preferencia del Caribe.

Sobre las desgracias acontecidas con motivo de esta importacion del
“ vomito negro,” hay numerosas memorias, siendo entre ellas digna de
apuntarse, la muy documentada que escribio D. Tadeo Lafuente, “ Medico
consultor Gefe de los Reales Exercitos, pensionado de S. M. Individuo
del Real Colegio Medico de Madrid, Academico asociado de la Real
Academia Medica Matritense y Comisionado repetidas veces, en calidad
de Inspector de la Salud Publica del distrito del campo de Gibraltar, por
los Excmos SS. Comandantes Generales del mismo,” Memoria que titulo:
Observaciones Justificativas y Decisivas Sobre que la Fiebre Amarilla
Pierde Dentro de Una Choza Toda Su Fuerza Contagiante y Sobre que
se Precave Tambien y se Cura de Un Modo Hasta Ahora Inf alible con
la Quina Tomada por Un Metodo Absolutamente Nuevo y Distinto del
que se ha Usado Comunmente, la que imprimio en Madrid, en la Imprenta
Real, en 1805.

Las graves noticias que juntamente con el interes peninsular por esta
plaga, recibia la Corte de Madrid sobre los episodios amarilicos que
desvastaban las costas americanas del septentrion: Nueva York, Filadelfia,
Boston y otros centros, por esos mismos anos— y cuyo estudio diera tanta
nombradia a esos famosos representantes de la Escuela Medica de Fila-
delfia, los Rush, los Cathrall y demas pioneros que lucharon contra estos
ictus demicos del tifus icteroides, decidieron al Gobierno espanol a dictar
medidas severas para prevenir la difusion de tan temida plaga a las vastas
tierras de la America hispanica.

La memoria ya citada del Doctor Lafuente, que nos permite conocer,
con lujo de detalles, lo que acontecio en el pueblo de los Barrios, vecino
a Gibraltar, y aun muchas noticias mas sobre la forma como la fiebre
amarilla asolo las tierras malagiienas y gaditanas, tuvo largo eco en la
Corte, y creo en ella la sensibilidad necesaria para comprender el peligro
que la fiebre amarilla constituia. Y que su autor supo pensar, lo revela
su adivinacion de que en la genesis de esta epidemia, habia algo que con-

260

MEDIDAS DE SEGURIDAD CONTRA LA FIEBRE AMARILLA 261

dicionado por el aire y la aglomeracion humana, jugaba papel primordial.
Fue el anuncio de lo que Finlay revelara anos despues, con su acusacidn
contra el Stegomya, de ser el vector y causante responsable de la epidemio-
gmesis amarillica.

Siendo de subido interes historico, para el concx:imiento de las in-
cursiones de la temida plaga, esta obra. la mencionamos unicamente para
sentar un postulado que tiene valor, como antecedente de la informacion
que contiene este pequeno estudio: que la preocupacion por prevenir la
difusion de la iiebre amarilla, tenia ganada a las autoridades de Madrid;
y que tal preocupacion fue no solo Metropolitana, sino que gano el deseo
de que fuera asimismo, preocupacion de tcxio el mundo hispanico, America
de preferencia, y en America, el Peru, opulento dominio, venero de la
riqueza de la Corona.

Con diligencia suma el Rey, D. Carlos IV, en realidad el omnipotente
Ministro D. Manuel de Godoy, Alvarez de Faria, Rios, Sanchez y Zarzosa,
Principe de la Paz y Regidor perpetuo entre otras Villas, de las de Malaga
y Cadiz, dirijio instrucciones especiales al entonces su Virrey y Repre-
sentante en Lima, D. Gabriel de Aviles y del Fierro, Marques de Aviles—
soldado de rigida dasciplina, obediente como el que mas, a la autoridad
real, y cuya dura mano de gobernante se dejo sentir, primero en Chile,
y despues en Buenos Aires, como Presidente y Virrey, respectivamente,
siendo promovido a Lima, el 20 de junio de 1800- a fin de que adoptase
las necesarias providencias para “ quarentenar ” las procedencias que
podian infectar el Virreynato, sobre todo las que podian venir de la
America Septentrional. “ Las relaciones insertas en la ‘ Gaceta de Fila-
delfia,’ tenian informada a la opinion espanola, de la situacion de New
York, por agosto de 1803, ciudad cuyo deplorable estado era un peligro.”
“ La calentura arrebata a los mas de los que acomete, y nada ha impedido
tanto que haya sido mucho mayor la mortandad, como la pronta salida
al campo de sus moradores.” La noticia la comenta Lafuente en su libro,
el que estaba precisamente dedicado al valido Godoy.

El Marques de Aviles, sin demora, curso tramite a las ordenes reales.
He aqui el interesante documento que dirijio a Truxillo, a las autoridades
que tenian a su cargo el gobierno del litoral norte del Virreynato, desde
el Cabo Blanco hasta Santa, y que comprendia los departamentos peruanos
de Piura, Lambayeque y La Libertad, posible primera puerta para que
entrara la fiebre amarilla en el Peru. Se da a la luz publica por primera.
vez: Decia asi el Virrey:

Uno de los medios mas efectivos para conservar la salud publica y preservarla de
los danos que sufre en las enfermedades, es evitar los contagios. Con este objeto

262

CARLOS ENRIQUE PAZ SOLDAn

son frecuentes, acertadas y sostenidas las disposiciones de todos los Gobiernos
civilizados. Hoy se hace mas exijente este cuidado sobre la declarada permanencia,
y extension de la fiebre amarilla en las provincias de los Estados Unidos de America,
cuyos Pescadores arriban a nuestros puertos con diferentes pretextos; es muy comiin
la opinion de que la peste que en el ano proximo pasado causo en Malaga tantos
estragos, ha renovado su malignidad, extendiendose por algunos puertos del Medi-
terraneo hasta Cadiz. Como no es posible tener en cada uno de los de tan dilatada
extension de estas costas una junta de sanidad que reconozca los barcos que se
presenten, y uno solo contagiado sea bastante para introducir la desolacion del
Reyno, es precise en defecto de este arbitrio ocurrir a los mas oportunos. Ninguno
mejor que el de no comunicarlos antes de asegurarse de la sanidad de los que los
montan. Infundir en el Pueblo, y particularmente entre los Pescadores de cada
distrito y entre los oficiales, y tripulaciones' de nuestros barcos mercantes el riesgo
inminente a que se aventuran si llegan con descuido a comunicar los buques ultra-
marinos: extender y persuadir estas noticias, ademas de ser un modo eficaz para
evitar el daho, concurrira no poco para excusar el contrabando; por que no es
presumible que ninguno convencido del peligro se exponga a el, sin muy violentos
estimulos. Encargo a Ud. pues, esta diligencia en todo el distrito de su mando,
y que sin perjuicio de ella expida las mas serias Providencias cuidando de su
cumplimiento, para que no se permita comunicar a ningiin buque de los que vienen
de Europa, antes de asegurarse si esta libre de peste, cuyo conocimiento puede
adquirirse intruyendose a la vez si trae enfermos o ha botada al mar algunos
muertos. Si resultase alguno de estos hechos, que precisa e incesantemente deben
comunicarse a los jueces territoriales mas inmediatos, enviaran estos si lo hubiere,
un medico, o cirujano para el reconocimiento con todas las precauciones necesarias
a no contaminarse, ni ellos ni los de su comitiva, y en caso de estar muy distantes
estos facultativos, se trasladaran ellos mismos, o comisionaran persona de conhanza,
discemimiento y prudencia que actue la diligencia, la que si es posible se hara
siempre con Escribano para dar a los buques extranjeros, o nacionales los auxilios
de hospitalidad que necesiten los unos, y todos los de costumbre que son debidos a
los otros, siempre que no haya temor alguno de peste en ellos. Pero resultando
haberla, y extendida inmediatamente la noticia entre los habitantes se les prohibira
toda comunicacion dandoles en distancia solo los muy precisos viveres, o medica-
mentos que pidan, y pueden necesitar para conducirse al Callao o pasar al ancla,
y con toda separacion la debida Quarentena. No necesito recomendar a Ud. la
importancia del asunto y espero de su parte la mayor vigilancia en el particular,
por su propio interes y el de la Poblacion que tiene a su cargo, con todas las demas
precauciones que le parezcan conducentes. Dios guarde a Ud.

(firmado) El Marques de Aviles.

AL Senor Teniente Asesor de Truxillo.

Lima, 4 de marzo de 1805.

Celoso el Dr. Dn Miguel Tadeo Perriz Cordova, Asesor de esa ciudad,
de dar cabal ejecucidn a lo que de esta suerte le ordenaba desde Lima el
Virrey, trascribio la nota a todas las autoridades que estaban bajo su
dependencia, sentando la diligencia siguiente, de acuerdo con la trami-

MEDIDAS DE SEGURIDAD CONTRA LA FIEBRE AMARILLA 263

tacion administrativa y las certificaciones que eran de uso durante el
Virreynato.

He aqui el decreto mencionado y la nota que envio al Cabildo, Justicia
y Regimiento de la Ciudad de Truxillo:

El Excmo Sor Virrey destos Reynos en su Superior Orden de cuatro del corriente
de que es copia la que acompano, me dice que para efecta de conservar la salud
publica, y preservarla de los danos que se originan en las enfermedades, es el de
evitar los contagios, tomando para ello todas las disposiciones acertadas de los
Gobiemos civilizados.—Esto dimana de una fiebre amarilla experimentada en
Malaga, con motivo de la peste comiin que bubo en el ano pasado, cuyos estragos
lenovo su malignidad, extendiendose por algunos puertos, por cuya razon se me
ordena no se permita comunicar ningun buque de los que vengfan de Europa antes
de asegurarse si esta libre de peste, adquiriendose a la voz de enfermos. Y siendo
preciso que V. S. S. tengan noticia de ello como Padres de esta Republica, se lo
comunico a fin de que por su parte coadyuben a tan importante asunto, por su
propio interes y el de la poblacion.

Dios guarde a V. SS. Ma. Truxillo, marzo 25 de 1805.

(firmado) Miguel Thadeo Perriz Cordova.

Al Muy Illustrisimo Cabildo, Justicia y Regimiento de esta Ciudad. Sala Capitular
de Truxillo, abril 4 de 1805; Guardese lo acordado en esta fecha y contestese.

(Tres Rubricas), Manuel Nunez del Arce.

Se contesto en dicha fecha lo que anoto, para constancia. Truxillo, fecha ut supra.

La autoridad del Cabildo y de los funcionarios locales de Truxillo, se
extendio a los que estaban bajo su jurisdiccion, como puede verse por esta
certificacion, que cierra el expediente que nos sirve para la presente
informacion:

Truxillo, marzo 15 de 1805. Guardese y ciimplase la Superior Orden que antecede
en todas sus partes, y para ello, en lo tocante a esta Capital y sus puertos, hagase
saber, y entender su contenida en copia certificada al Ilustre Ayuntamiento, y con
otra igual a los Subdelegados de Lambayeque y Piura, y sus respectivos Administra-
dores, con encargo a los primeros de que comunicandola a los respectivos Parrocos,
se insinuen favor de que la divulguen, y hagan saber a sus Feligreses Pescadores
para que por todos los medlos se precaucione el grave dano que amenaza el Con-
tagio recelado. Hagase igual diligencia con el Alcalde ordinario de Espanoles de
San Pedro por lo tocante al Puerto de Pacasmayo; y prevengrase a los Guanchaco
y todos sus mandones el que por virtud de las ordenes antecedentes dadas sobre
dcber avisar el arribo de cualquiera buque; cuiden en lo sucesivo de no permitir la
comunicacion, ni desembarque de cualquiera otro que venga, sin que antes se hayan
hecho las averiguaciones que se previenen, absteniendose de la incauta prontitud
que hasta aqui han acostumbrado de salir al encuentro en sus lanchillas de los
huques que aparecen, si no se cerciorasen antes de ser tal traficado en estas nuestras
Mares, y para ello comparezcan librandose el orden correspondiente, y acusese

264

CARLOS ENRIQUE PAZ SOLDAN

recibo a S. E. con copia desta Providencia, y ofrecimiento el mas eiicaz, y sincere
de que nada se omitira en el cumplimiento de tan interesante objeto. Doctor
Cordova.

Es copia de su original, asi lo certifico-Norberto Manrique, Secretario.

Que este asunto fue para el propio Virrey, de interes sumo, lo acredita
el hecho de que en la Relacion oficial que dejo de su Gobierno, signada
el 27 de julio de 1806, a su sucesor D. Fernando de Abascal,—fundador
que fuera del Colegio (fc Medicina de San Fernando y de tan gloriosa
memoria—recuerda este acto administrative y sanitario: “Con igual
actividad ha de impedirse la propagacion de los males que el descuido
facilita se introduzcan en los pueblos por la libre comunicacidn con los
infectos de contagio. Esta triste plaga que desde el ano 1800 en que fondeo
en la Bahia de Cadiz la corbeta Delfin, procedente de Boston, principio
sus estragos en aquel puerto y sus inmediaciones, se ha extendido en los
sucesivos en toda la Peninsula, siendo muy dolorosas las ultimas noticias
de sus homicidas efectos.”

“ Para evitar, continua la Relacion, los que podian haberse trasmitido
por la fragata de la Real Compania de Filipinas, la “ Fernando o Principe
de Asturias,” que arribo al Callao en 7 de marzo del pasado ano, salida
de Cadiz el 8 de octubre anterior, juzgue inevitable sujetar a ese buque
a formal quarentena delegando para esa comision al Sr Alcalde del Crimen
D. Jose Baquijano y Carrillo, por haber tenido en su navegacion tres
muertos con los sintomas de epidemia y prevenir la Junta de aquel puerto
en el pase de sanidad no se omitiese una observacion vigilante a su llegada.”

“ Las providencias tomadas para la seguridad y precaucion, destinando •
lugar en que situar la fragata, el metodo de verificar la descarga de sus
efectos, el de ventilarlos y perfumarlos, con los equipajes, tripulacion y
pasajeros, y todas las demas economicas y de arreglo, se hallan reunidas
en el expediente formado en el asunto, que se halla archivado en la Secre-
taria de Camara, donde podran tomarse los datos oportunos en el caso
de repetirse igual suceso.”

Todo evidencia el alerta temor que se tenia de la introduccion de la
fiebre amarilla en el Peru. El proposito fue plausible, aun cuando los
fundamentos doctrinarios de entonces fueran falsos. Para el Virrey, quien
era apenas eco de la opinion profesional de los medicos de la epoca, “ Las
epidemias y pestes, que en lo moral son castigo del Cielo, en lo fisico son
siempre originadas de los vapores mefiticos que exhalan los cuerpos cor-
rompidos.” Era la doctrina, reinante desde los dias de Carlos III, y que
consagrd esa reforma senalada por el gran Monarca para que se erigiesen
cementerios en las grandes ciudades,” a fin de que cesara la inhumacion

MEDIDAS DE SEGURIDAD CONTRA LA FIEBRE AMARILLA 265

de los cadaveres en las Iglesias, reuniendose con los del Estado, han con-
spirado con esfuerzo a desterrar de los templos la inhumacion de los
cadaveres, formando para sepultarlos campos santos, en parajes distantes
y ventilados, para que, como se explica por el sabio Rey D. Alfonso,
en una de sus leyes: “ El fedor de los muertos, no cause la ruina de los
vivos.”

Leidas las providencias que dejamos consignadas, con nuestros ojos
aleccionados por el adelanto de la Higiene, no dejan de ser interesantes
para quienes estudian la lenta evolucion de las ideas exactas.

Apuntemos las que se profesaban entonces: el contagio, he ahi lo funda¬
mental para establecer la insalubridad; la conviccion de que “ uno solo
contagiado sea bastante para introducir la desolacion del Reyno,” idea
justa, que despues, con esa nocion falsa de “ foco,” sufrio algiin eclipse;
la ventaja de la incomunicacion total, para prevenir enlaces epidemio-
genicos; la posibilidad de utilizar la voz Humana, para !a debida in-
formacion sanitaria, como hoy lo hacen aviones y barcos, por medio de
la radiotelegrafia; la obligacion de asistir a los barcos contaminados, sin
por ello permitirles ser agentes de difusion de una enfermedad. He aqui
normas administrativas, hijas de la experiencia y del buen sentido, que
el Peru conocio y practice, desde mucho antes que el genio de Pasteur,
alumbrara los caminos seguros para las tecnicas sanitarias maritimas y
navieras.

Frente a las epidemias, ninguna medida mejor practicaba la epoca. como
seguir ese consejo de la sabiduria popular: huir en las alas de las tres eles:
lejos, luego y largo tiempo. Dispersion demotica, por los siglos util a la
defensa de la vida Humana, no importa ante que p>eligro: una epidemia
0 un bombardeo. Es verdad que contra este medio primitivo y ciego, se
creo el freno de los ” cordones sanitarios,” medida cruel, que sin embargo
tuvo aceptacion universal, por anos.

La fiebre amarilla no ataco entonces, ni habia atacado antes al Peru,
Solo a mediados del siglo XIX y a comienzos del XX, padecimos de dos
pequenos brotes importados por los grandes barcos de vapor. Nuestro
suelo refractario al Tifus Icteroides, no cuenta con el, en su registro de
morbomortalidad, salvo las alarmas periodicas, mas teoricas que reales,
que de vez en vez se pretende crear con la llamada Fiebre amarilla
selvatica.

Para nuestros lejanos abuelos, las medidas que adoptaron, y que aqui
recordamos, alcanzaron pleno exito favorable. Ello les dio la tranquilidad
de conciencia, ante el deber cumplido.

Las noticias que anteceden, breves quizas, solo tienen un valor: que

266

CARLOS ENRIQUE PAZ SOLDAN

estan ofrendadas al numero especial del Bulletin of the History of Medi¬
cine, esta antorcha que por las sombras del presente mantiene encendida
para orientacion del pensamiento continental, Henry E. Sigerist, el ejem-
plar Maestro de Johns Hopkins; y dedicadas a servir para la gloria de
Arturo Castiglioni, el gran historiador medico y gran legionario de la
sanidad universal, en sus dias de energia cientifica cuando defendia contra
importaciones peligrosas, esas tierras que bana el Mar Mediterraneo, mar
que el destine, una vez mas, parece reservar para las decisivas batallas
por la Civilizaci6n, a la que alumbrara de nuevo, la luz de la Latinidad,
que al retomar de la America, con nuevos fulgores, permitira a los hom-
bres que han de sucedernos, y a nosotros mismos, vivir en la Libertad,
en la Tolerancia y en la Fraternidad universales.

DER ZAHNBRECHER DES HANS SACHS
CURT PROSKAUER

Wenn uns fur unsere Kenntnis vom Leben und Treiben der “ fah-
renden,” auf Jahrmarkten und oflFentlichen Platzen im sechzehnten
Jahrhundert ihre Tatigkeit ausiibenden Zahnbrecher keine andere Quelle
zur Verfiigung stehen wiirde, als ein bisher unbeachtet gebliebener
Schwank des Niirnberger “ Schuhmacher und Poet dazu ” Hans Sachs/
der einen Bader und einen Zahnbrecher als Hauptpersonen in ihm agieren
lasst, so wurde diese Dichtung allein ausreichen, uns ein anschauliches
Bild von der Art offentlichen Auftretens dieser volkstiimlichen Gestalten
zu ubermitteln.

Da dieser Schwank weder in der Arbeit von I. Fischer/ die sich
eingehend mit der Heilkunde bei Hans Sachs befasst, erw^nt, noch
jonst in medico-historischen Publikationen trotz seiner kulturgeschicht-
lichen Bedeutung verwertet worden ist, soil er hier veroffentlicht werden.
Die zu diesem Zwecke benutzte Einzelausgabe/ ein diinnes Quart-
bandchen von nur 4 unbezeichneten Blatt, also 8 unnumerierten Seiten,
tragt den Titel:

Ein Gesprech eyner/ Bulerin vnd eines ligenden Nar/ren vnter jhren
Fiissen./

Hans SacTjs./ [Das h in dem Worte Sachs ist versehentlich auf den
Kopf gestellt]

Der das Titelblatt schmiickende Holzschnitt stellt eine geputzte Frau dar,
zu deren Fiissen ein Narr liegt. Die letzte Seite zeigt das Impressum,
ohne Jahreszahlangabe:

Gedruckt zu Niimberg durch/ Herman Hamsing./

Zwischen Impressum und Textschluss befindet sich eine Holzschnittleiste,

’Hans Sachs (geb. 5. November 1494 in Nurnberg, gest. 19. Januar 1576 ebenda),
von Richard Wagner durch “Die Meistersinger von Niimberg” weitesten Kreisen
nahegebracht, hat mehr als 6000 Dichtungen der verschiedensten Art geschrieben. Seine
Schwanke, deren Stoffe meist dem Volksleben entnommen sind, gehoren zu seinen besten
und beliebtesten Leistungen, die mit dazu beitrugen. ihn zu dem bekanntesten deutschen
IJichter des 16. Jahrhunderts zu stempela Sein dichterisches Eintreten fur Luther’s
Bestrebungen verkniipfen Sachsen’s Kunst und Namen eng mit dem Reformationszeitalter.

*1. Fischer (Wien): Die Heilkunde bei Hans Sachs. Wiener Medizingeschichtliche
Beitrdge. Heft 3. II. Wien 1937.

’ Mr. Henry Schuman, New York, spreche ich meinen Dank dafiir aus, dass er mich
auf das in seinem Besitze behndliche seltene Exemplar aufmerksam gemacht und mir die
Anfertigung von Photos gestattet hat.

267

268

CURT PROSKAUER

die einen Wald mit Hirsch, Einhorn, Bar, Hasen und anderen Tieren
darstellt, zu dem Inhalt des Druckes selbst also keinerlei Beziehung auf-
weist. Die auf das Titelblatt folgenden beiden Seiten enthalten die auf
den Xitel beziiglichen monologartigen Verse der Buhlerin und des Narren,
und erst auf der vierten Seite beginnt der Schwank, betitelt:

Der Bawren Ader/lasz, sampt einem Zanbrecher./

Nach Goedeke* ist der Schwank im ersten der drei starken Foliobande*
zu finden (No. 529), in denen Hans Sachs selbst seine Reimgedichte,
meist mit Angabe des Entstehungsdatums, vereinigt hat. Als Tag der
Beendigung des Schwankes ist dort der 22. September 1557 angegeben,
ein Datum, das auf einem Irrtume des Dichters beruht, da der Bauem-
schwank bereits im Jahre 1554 zusammen mit dem Buhleringesprach in
einem selbstandigen Quartbande in Nurnberg erschienen ist. Goedeke
kann fiir die sonderbare Ansetzung des spateren Datums in der Gesamt-
ausgabe der Sachs’schen Gedichte keine Erklarung finden. Eine dritte,
die hier vorliegende Ausgabe, wurde von Hermann Hamsing in Nurnberg
ohne Jahresangabe herausgebracht. Da aber die meisten bei Hamsing
crschienenen Einzelausgaben der Hans Sachs’schen Gedichte. soweit ich
feststellen konnte, zwischen 1552 und 1556 gedruckt wurden, die erste
Ausgabe des Bauemschwankes aber 1554 erschienen ist, diirfte unser
Druck zwischen 1554 und 1556 die Hamsing’sche Presse verlassen haben.

Der altdeutsche Text des Sachs’schen Schwankes bereitet mit seinen
sprachlichen und orthographischen Eigentumlichkeiten auch dem Kenner
der deutschen Sprache Schwierigkeiten. Ich habe daher ausser dem
reproducierten Originaltext eine Ubertragung in eine leichter verstand-
liche Form gesetzt, die sich in der Hauptsache auf eine Modemisierung
der Orthographie beschrankt. Da ich mich dabei von dem Original nicht
allzuweit entfernt habe, sind fiir manche Worte Erlauterungen notwendig
geworden, von denen jedoch dort Abstand genommen worden ist, wo
bei zuerst schwer verstandlichen Worten und Satzen sich der Sinn bei
lautem Lesen aus dem Zusammenhange selbst ergibt. Die zu erklarenden
Worte sind in der alten Orthographie des Originals an den Anfang
jeder Erlauterung gestellt, die in der Hauptsache dem umfangreichen
Deutschen Worterbuche der Gebriider Grimm* sowie dem Deutschen
Krankheitsnamen-Buche von Hofler^ entnommen sind.

* Karl [Friedrich] Goedeke: Grundriss rwr Geschichte der Deutschen Dichtung aia
den Quellen. 2. Band: Das Reformationsseitalter. Dresden 1886. S. 432 No. 344.

* Dieser erste Folioband erschien 1558 in Nurnberg, die beiden andem in den Jahren
1560 und 1561. In einem 1590 herausgebrachten Nachdruck ist der Bauernschwank als
No. 396 enthalten.

•Grimm, Jacob u. Wilhelm: Deutsches Worterbuch. Leipzig, S. Hirzel, 1854ff.

* Hofler, Max: Deutsches Krankheitsnamen-Buch, Munchen 1899.

DER ZAHNBRECHER DES HANS SACHS

269

• Aderlasz—hat ausser der medizinischen

Bedcutung auch den Sinn, jemandon
sein Geld abnehmen. Diese Doppel-
bedeutung scheint hier mit Absicht
verwendet zu sein. (Gr. I, 180)

• Dettelbach—Stadtchen in Unterfranken,

Bayern, nahe bei Wurzburg.

• Kram—Krambuden, in den Stadten

meist an Kirchen, Rathausem, auf
Brucken und Platzen aufgebaut (Gr.
V, 1987)

♦Kolchte—kolnisch, kolnisch-blau. (Gr.
V, 1622)

• Schlotterleyn—Schelle, Klapper. (Gr.

IX, 788)

• Nestel—Heftnadel, Riemen, schmales

Band, Bandschleife. (Gr. VII, 626)

' Pfeyffen—Pfeifen = Blasinstrumente.

• Schaubhut—grosse, runde Hute aus

Stroh mit breitem, nach unten ge-
zogenen Rande. Tracht des weib-
lichen Landvolkes.

• Spitzpartn—spitze Partisane, Waffe.

** Mit Hauffn—in Fulle, reichlich. (Gr.

IV*, 586)

“ Kirchtag—^Jahrmarktsgeschenk (Gr. V,
827)

** Mdstel—Mostler, Mann, der den Most
austritt, ausquetscht. (Gr. VI, 2600)

“ Ringen Beutel—geringen, leichten Beu-
tel, nicht viel Geld haben.

**• Ruszdurrer—rossdiirr, sehr mager.

“ Hundsmuckn — cynomia, Hundsfliege.
Das Wort wird auch als Bild fiir
Launen, ahnlich wie das vorherge-
hende Grillen gebraucht (Gr. IV*,
1939) Die Grille sticht den Menschen,
sie verfuhrt ihn zu allerlei Ausge-
lassenheit. (Gr. X*, 1259)

Der Bauern Ader-
lass,^ sampt einem Zahnbrecher.

ES ist nicht lang, dass es geschah,

Dass Kirchweih war zu Dettelbach,*
Darauf ich auch geladen ward.

Da macht ich mich bald auf die Fahrt.
Da ich nun auf die Kirchweih kam,
Da sah ich gar manchen Kram*

Mit Lebkuchen und gebranntem Wein,
Kolnische* Haarband’ und Schlotter-
lein,*

Mit Giirtel, Beutel, Nestel,* Taschen,
Mit roten Schiisseln und blechernen
Flaschen,

Pfeifen,* Schaubhiit,* Wiirfel und
Karten,

Lange Messer und Spitzparten.®

Da taten die Bauemknecht mit Haufen *®
Den Bauemmadchen des Kirchtags”
kaufen.

Ich ging in den Kramen hin und her,
Indent ersah ich ohngefahr
Bei des Baders Haus sitzen allein
Einen feisten Mostel “ auf einem Stein.
.Der hatt’ in ihm viel faules Blut,

Ein’ geringen Beutel** und schweren
Mut.

Bei dem stand ein russdiirrer *** Bader,
Der dem Bauer schlagen sollt’ ein’ Ader,
Derselbig hatt’ an ein paar Brillen,
Und hatt’ im Kopf gar seltsam Grillen,
Um ihn stachen die Himdsmucken.**
Nach dem tat er sein Lasszeug zticken.

270

CURT PROSKAUER

**Fliten—Flitte, phlebotomum, Lasseisen,
Bestandteil des vorheiYdienden Lasz-
zeag. (Gr. Ill, 1805)

Zwelffer Week—Backwerk, Brot in
langlich runder Form. Nach Umfang
und Preis verschieden gross. Man
spricht daher von Pfennig-, Heller-,
Kreutaer-, Groschen-, Scchser- und
Zwolferweeken. (Gr. XIII, 2788)
Katz—kann auch auf Menschen, be-
sonders auf alte, bose Weiber, wie
hier wohl der Fall, angewendet werden
(Gr. V, 287)

Hering—der gebratene Hering gilt als
Leckerbissen, daher sprichwdrtlich;
man muss dem Bauer oft einen Hering
braten, d. h. das Maul schmierea (Gr!
IV*, 1105)

*• (joder—Gurgel, Kdile, Schlund. Be-
deutet einfach trinken.

*® Hoffiert—singen, ein Standchen brin-
gen, aufspielen (Gr. IV*, 1682)

** Quintem—Quinteme (aus quintema),
kleine Laute mit 5 Saiten. Saiten-
spiel. (Gr. VII, 2374)

** Kirchtag—das kirchliche Fest mit den
begleitenden weltlichen Lustbarkeiten
(Gr. V, 827)

Seine Flittewar | ein eisemer Keil,
Die setzt er auf mit schneller Eil’.
Schlugmit einemWestfalischen Hamai
Als ihm das Blut entging allsamen,
Da verier er gleich seine Kraft,

Da schrie er nach einem Rebensaft.

Da kam ein Franke mit einem Krug
Und gab ihm des Safts eben genug,
Nach dem ihn vorher hatt’ lang ge-
diirstet,

Ein zwolfer Weeken^* und zwei Brat-
wiirst’.

Damach tat er den Kranken laben
Und sprach, er solt’ sich wohlgehabea
Eine Katz’,^^ die ware unten sein Koch,
Die briet’ ihm Wurst’ und Hering***
noch.

Auch stund im Kuhlwasser eine
Flaschen,

Damit mocht er sein Coder ** wasdien.
Vor ihm hofiert ihm einer gem,

Ein Mannlein auf einer Quintem,**
Das ihm viel Liedlein darin sang,

Es dreht sich um, hupfte und sprang.
Da lacht ich mir der Aderlass,

Ging im Kirchtag ** weiter meine Strass.
Wann ich sah dort eine grosse Meng*
Der Bauem, die mit ein’m Gedrang,
Mit Lachen und grossem (jetos*.

*11 Diese selbe Bezeichnung fand ich in Jacobus Theodoras Tabernaemontanus: Neuw
Kreuterbuch . . . Franckfurt am Mayn, 1588. Seite 370, E: [Eusserlicher gebrauch der
Ber-/thramwurtzel] Die Zahn selbest machen auszfallen. Nimb Ber-/thram, Schampanier-
wurtz Oder weisz Nieszwurtz, . . . Stosz die/ zu Puluer, temperiers damach mit Essig
zu einem/ Salblein, lasse das Zahnfleisch tmd den schmertshaffti-/gen Zahn bicken
[picken] mit einer Flieten, vnd reibe dasselbige/ ort desz Tages offtermals darmit, es
hilfft, . . .

DER ZAHNBRECHER DES HANS SACHS

271

••Drischeln—Dreschflegel (Gr. II, 1421)

**Kropffcter—mit einem Kropf behaftet.
(Gr. V, 2402)

’•Paul—Caries, (jeschwursbildung, Faul-
nis (sordes, putrido) (Gr. Ill, 72)

*• Zipperleyn—Gicht

Plow Husten—Blauer Husten, Keuch-
husten, bei dem man im Gcsicht
infolge der krampfhaften Anstrengung
blau (cyanotisch) wird. (Gr. IV®,
1977)

Weynsteyn—Zahnstein.

**Meuchler—Name einer fieberiiaften,
nicht naher bestimmbaren Erkran-
kung. (Gr. VI, 2162)

Sant Vrbansplag—Milzbrandrotlauf.

Mit Stiefeln hatten ein Gestoss’,

Mit Schweinspiess, Drischeln” und
Mistgabein

Taten fast durcheinander krabbeln
Herum, ringweis um einen Kram.

Und als ich dem auch n^er kam.

Da war allda ein Zahnbrecher,

Ein Bauembescheisser g^r ein frecher,
Derselbig’ fing zu schreien an:

Her! Her! wer hat ein’ bosen Zahn ?
Ein boser Zahn, ein boser Cast,

Lasst dem Mann weder Ruh noch Rast.
Zu dem drang ein kropfeter** Mann,
Der hatt’ einen bosen, hohlen Zahn.
Der setzt’ sich und reisst auf sein Maul
Aufs weitest’ wie ein Ackergaul.

In’s Maul griff er ihm mit der Zangen,
Sein’ bosen Zahn heraus zu langen.

Da ergriff er ihm einen unrechten.

Da Hess er einen Schrei mit Machten,
Fuhr auf vom Stuhl imd lief davon.
Da fing erst der Zahnbrecher an:
Kommet herbei! herbei! herbei!

Ich hab gar gute Arzenei
Fiir das FauP® und den Zipperlein,**
Fiir den blau Husten*^ und den Wein¬
stein,®®

Fur den Meuchler,®* Sant Urbansplag,*®

272

CUKT PROSKAUEK

Gnimmen ob dem spiel—Geschlechts-
krankheit. Spiel — weibliches Ge-
schlechtsglied, in manchen Gegenden
Geschlechtsteil uberiiaupt. (Gr. X^,
2319)

** Sehnen—Sehnsucht, besonders auf die
Liebe bezogen (Liebestrank) (Gr. V,
151)

*» Lauffendt—Stuhlgang, Durchfall (Gr.
VI, 320)

** Krampff—spasmus. Unter Esels-oder
Hundskrampf versteht man das Ver-
ziehen des Mundes nach den Ohren,
aber auch den Kinnbackenkrampf (Gr.
V, 2010)

»s Ragwurtz—orchis (Gr. VIII, 62)

**Wurmsamen—Mittel gegen Wurmer
(Bandwurm oder Eingeweide-
wurmer)

Driacker — Theriak. Eine aus zahl-
reichen Mitteln zusammengesetzte,
sehr beliebte Arznei, die als Haupt-
bestandteil Opium enthalt. Angeblich
(and sich auch Vipemgift darin, wes-
wcgen auf einigen Zahnbrecherdar-
stcllimgen (Jost Amman) zusammen-
geknaulte Schlangen zu sehen sind.
Theriak gait als Antidot bei Ver-
giftungen und als besonders wirksames
Pest-Praeservativ.

*• Mucknschwammen — Fliegenschwamm
(Gr. IX, 2195)

*• Schmer—Fett (Gr. IX, 1030)

Grosz Bauchet Weyb—gravida, schwan-
ger. Hier sind die (Seburtswdien
gemeint.

** Pfercht—cacare (Gr. VII, 1674)
Schragn—schrag oder kreuzweise steh-
endes Holzwerk, Tisch des Kramers,
Brettcrgerust. (Gr. IX, 1623/24)

** Furm—Form

** Kramschatz—Bedeutet hier Ware.

Fiir’n Gnimmen ob dem Spiel ich sag.
Fur die Eifersucht und das Sehnen,"
Fiir’s Laufen,*® Krampf®* und bose
Zahnen,

Dazu mancherlei Wiirz ich han,
Ragwiirz,*® Senf und Enzian,
Petroleum und Wurmsamen,®*
Driackers*^ und gut Miickenschwam-
men.**

Ich hab gut’ Salben fiir die Laus’,
Gut’ Pulver fiir Ratzen und Maus’,
Und hab’ auch fiir die Floh’ gut
Schmer,®*

Darum: wolher! wolher! wolher!

In dem ein Bauer zu ihm kiimmt,

Der sich sehr hin und wieder kriimmt,
Geleichsam einem dickbauchigenWeib."
Der hat die Wiirm in seinem Leib.
Dem er ein Wiirmsamlein gab
In einer Milch ihn flosst hinab.

Bald biickt er sich vmd tat sehr klagen,
Und pfercht*^ ihm nieder auf den
Schragen.*®

Etwas fast auf ein Dutzend Wurm,
Kurz und lang auf allerlei Fiirm,**
Die der Wurmsamen hat von ihm
g’trieben,

Um ihn die Sau’ sich fleissig rieben.
Als nun bewert war sein Wurmsamen,
Die Bauern sein danach all nahmen.
Also ging ich von diesem Platz,

Lacht mir der seltsamen Kramschatz.**

DER ZAHNBRECHER DES HANS SACHS

273

Diesem Sachs’schen Schwanke kommt eine umso grossere kultur-
historische und medizingeschichtliche Bedeutung zu, als er die einzige
umfangreichere textliche Quelle aus der Zeit der Reformation darstellt,
die uns fiber die Art der Tatigkeit damaliger Zahnbrecher ausfuhrlichere
Auskunft gibt. Die sonstigen textlichen Quellen aus diesem Zeitabschnitt
--ebenso wie aus friiheren Jahrhunderten—, die uns fiber die Zahnbrecher
_ informieren, fliessen nur sehr sparlich. Sie bestehen im wesentlichen in
einigen Verordnungen imd Aktenvermerken, die sich noch in den Rats-
archiven der verschiedenen Stadte und Lander Europas vorfinden, und in
ganz kurzen gelegentlichen Bemerkungen in medizinischen Schriften und
Krauterbfichem jener Zeit. Sie beschriinken sich in der Regel darauf,
den Zahnbrecher in eine Reihe mit den verachtetsten und geradezu
geachteten Berufs-oder Personengruppen zu stellen, den “ alten Weibern,
Gauklern, Juden, Theriaks- und Wurzelkramern, den Krautgrasern und
dergleichen Landfahrern oder vielmehr Leutebescheissern.” * Einen Ein-
blick in die Berufsausubung der Zahnbrecher zu gewinnen, ermoglichen
diese Quellen nicht, es wiederholt sich dort nur der stets allgemein
gehaltene Vorwurf der Quacksalberei, der Unwissenheit unddes Betruges.
Die Methoden ihrer Behandlung, die Art ihrer Kundenwerbung, der
Kreis ihrer Patienten und deren Psyche, die von ihnen fur ihre Tatigkeit
bevorzugten, stets wechselnden Orte und Zeiten, das Aussehen und die
Ausstattung der Statte ihres Wirkens, all dies ist diesen Quellen nicht
zu entnehmen. Hier ffillt der Sachs’sche Schwank eine Lficke aus, sein
dem L’eben wahrheitsgetreu entnommener derber Stoff mit der Schil-
derung des Auftretens eines Zahnbrechers und seiner Wirkung auf das
Publikum wird uns gleichsam wie eine vor unsern Augen abrollende
VVochenschau zeitdokumentarisch vorgeffihrt. Sachsen’s personliche Stel-
lungnahme zu den von ihm geschilderten Vorg^gen aussert sich in seinem
Spott fiber das marktschreierische Treiben des Zahnbrechers sowie den
im Volke verbreiteten Aberglauben und die kritiklos hingenommene
Kurpfuscherei.

* Walther Hermann Ryff: Reformierte Deutsche Apoteck . . . Strassburg, Josias Rihel,
1573. Fol. 220^: "... alt Weib, Zanbrecher,/ Gauckler, Lumpenkremer, Krautgraser
Wurtzlen kremer vnnd der gleichea/ Landfarer, oder vil mehr Leiitbescheisser ...”

Fol. 195^: "... Die Zanbrecher, Wurtzel graber,/ Landfarer vnd solches gesind . . . ”

Fol. 196^: “ Der gemein Alraun oder Mandragora/ welche von den Zanbrechem, Wurtzel-
grabem vnnd Landfarem (vnder dem/ Galgen, daran sie gehdren, welcher am niitzlichsten
were) ausz gegraben werde ...”

Fol.46»: “. . . als vil ich geschweig der landfarer, zanbrecher, Tiriacs vnd wurtzeln
lcra-/mer, welche die einfeltigen, auch vnderweilen die so sich vast gescheid vnd sehr
klflg be-/duncken, augenscheinlich vnd offentlichen betriegen, darzu mit gesehenden augen/
blind machen vnd bereden kdnden, was sie wollen, &. / . . . ”

cr^^narccJ^rr*

r fyiu <m bdfen

5Deiife(f>rn icl) au^brfc^ftt fait/

X)n ttw^togn / iric man gbiVrt DfV .f inb^r/
3(ucl} ^ob icb i^rainfcba^ mc^t bf ftmiiiDr/
(p^trelium »nDQ[Curmfaiiifn/
jX^riarffi unD Difl 0)?i5cfertffl}tt)«mm/
^abaiKfj0ut0a(bn/fiU
^uc^PulurtfiirO^abrn

Edentarius. ^SDcr^anbrccf^***

f^ViJipiit habes loMgo butrefkSotteporedtmttt^
^"^1 ’vacillantes has tituhare 'vides,
hie^Httes immodicos herbit Jauaredolortf,
tibifaritertnx cr amara dies.

Hue ades at a meat emftar ne dejpice mercest
Furfitaubltaliijuam reperiemut opem.
Sirameu baudali<juidtepharmdtafera iuuabuut^
Dextera neepoteritferre medentit opem.
Strenuus eripiam ttbi for/ice ton for acutUy
Et rabidodeutem Juppedltako taut.

Tape-

274

CURT PROSKAUER

Noch eine zweites Mai, in einem seiner Achtzeiler, die als textlich
erlauternde Unterschriften unterdie “ Standebuch” — Holzschnitte seines
Landsmannes Jost Amman gesetzt sind, hat der Niimberger Meistersinger
den Zahnbrecher in Versen beschrieben. Wahrend uns aber Hans Sachs
in seinem Schwanke als teilnehmende Zuschauer mitten im Getriebe eines
Kirchweihfestes mit seiner drangenden und stossenden Menschenmenge
vor dem Stande eines Zahnbrechers eine Zahnextraktion mit allem Drum
und Dran ihres dramatischen Verlaufes miterleben lasst, kann er in den
wenigen ihm fiir die Bildunterschrift zur Verfiigung stehenden Zeilen
nur das in Verse fassen, was ihm offenbar am charakteristischsten an
einem lunherziehenden Zahnbrecher erscheint; das laut schreiende An-
preisen seiner Kiinste und Heilmittel. Diese Verse gleichen im iibrigen
inhaltlich denen, die er viele Jahre friiher in seinem Schwanke verwendet
hat.

Der Zanbrecher.

Wolher, wer hat ein bdsen Zan?

Denselben ich auszbrechen kan,

On wehtagn, wie man gbiert die Kinder,

Auch hab ich Kramschatz nicht destmindr,

Petrolium vnd Wurmsamen,

Thriacks vnd viel Muckenschwamen,

Hab auch gut Salbn, fiir Flohe vii Leusz,

Auch Puluer fiir Ratzen vnd Meusz.

Dieser Achtzeiler erschien zum ersten Male in einem Werke, das der
bekannte Frankfurter Verleger Sigismund Feyerabend* mit 114 Holz-
schnitten des Jost Ammanim Jahre 1568 in der Presse des Georg Rab
drucken Hess:

Eygentliche Beschreibung/ Aller Stande auff Er-/den, Hoher

* Sigismund Feyerabend, geb. 1528 in Heidelberg, war Buchdrucker und Formschneider
in Frankfurt am Main. Er stand mit vielen andem Buchdruckem Frankfurts in Ver-
bindung und hatte als Verleger fast den g^anzen Buchhandel dieser Stadt in seinen Handen.
Anfang der sechziger Jahre schloss er mit Georg Rab und Weigand Han eine Firmenge-
sellschaft, die eine grosse Zahl von Verlagswerken hervorbrachte. Naheres in; Lexikon
des gesamten Buchwesens. Von Karl Loffler und Joachim Kirchner. Bd. I. S. 536.
Leipzig 1935.

**Jost Amman, 1539 in Zurich geboren, kam 1561 nach Niimberg, wo er als Maler,
Zeichner (“Reisser”), Formschneider, Kupferstecher und Radierer wirkte. Nach dem
Tode des fiir den Feyerabend’schen Verlag als Illustrator und Omamentist tatigen
beruhmten Virgil Solis (1562) nahm Amman dessen Stellung ein und wurde der
bekannteste der fur den Bilddruck tatigen Meister seiner Zeit. Die Standebuchblatter
ziihlen zu seinen besten Blattfolgen. Er starb 1591.

276

CURT PROSKAUER

vnd Nidriger, Geistlicher/ vnd Weltlicher. Aller Kiinsten, Hand-
wercken/ vnd Handeln, &. vom g^osten bisz zum kleinesten/
Auch von jrem Vrsprung, Erfindung vnd/ gebreuchen./ Durch
den weitberiimpten Hans Sachsen/ Gantz fleissig beschrieben,
vnd in Teutsche Reimen ge-/fasset. Sehr nutzbarlich vnd lustig
zu lesen, vnd auch mit kiinstreichen/ Figuren, deren gleichen
zuvor niemands gesehen, alien Standen/ so in diesem Buch be-
griffen, zu ehren vnd wolgefallen. Allen/ Kiinstlern aber, als
Malern, Goldschmiden &./ zu sonderlichem dienst in Druck/
verfertig^./ Mit Rom. Keys. Maiest. Freyheit./ Gedruckt zu
Franckfurt am/ Meyn,/ M. D. LXVIII. [Am Ende:] Gedruckt
zu Franckfurt am/ Meyn, bei Georg Raben, in/ verlegung
Sigmund Fey-/erabents./ M. D. LXVIII./

Eine zweite Ausgabe mit gleichem Titelinhalt erschien einige Jahre spater,
cbenfalls “ in verlegung S. Feyerabends in Franckfurt durch R. Refflern.*
1574.”

Gleichzeitig mit diesen beiden deutschen Ausgaben brachten in den
selben Jahren 1568 und 1574 Feyerabend und Rab auch lateinische Aus¬
gaben mit den gleichen Holzschnitten des Jost Amman imd mit lateinischen
Distichen des Poeten Hartmann Schopper heraus.” In diesen Ausgaben

‘^iv, 114 unbez. Bll. m. 114 Holzschnitten, i Bl. (Impressum u. Druckermarke).

‘*Der erste dieser beiden Drucke hat den Titel: HANOIIAIA [Panhoplia], omnium
illiberalium mechanicarum aut sedentariarum artium genera continens, quotquot unquam
vel a veteribus, aut nostri etiam seculi, celebritate excogitari potuerunt, breviter et dilucide
confecta: carminum liber primus, tiun mira varietate rerum vocabulorumque novo more
e.xcogitatorum, copia perquam utilis, lectuque perjucundus. Accesserunt etiam venus-
tissimae imagines, omnes omnium artihcum negotiationes ad vivum lectori representantes
antehac nec visae, nec unquam editae: per Hartman Schopperum, novoforens.
norictun. [Am Ende;] Impressum Francofurti ad Moenum, apud Georgium Corvinum
[Rab] impensis Sig. Feyerabent. 1568.

Der Titel des zweiten lateinischen Druckes ist abgeandert in: De Omnibvs Illiberalibvs
Sive Mechanicis Artibvs, Hvmani Jngenii sagacitate atque industria iam inde ab exordk)
nascentis mundi vsque ad nostram aetatem adinuentis, luculentus atque succinctus Liber:
Avctore Hartmanno Schoppero, Novoforensi, Norico, versu Elegiaco coscriptus: & ele-
gantissimis ac artihciosissimis iconibus, vniuscuiuslibet Opificis officia, negociaqz ad
viuum adumbrantibus, exomatus. Francofvrti Ad Moenvm, 1574. [Colophon:] Impressum
Francofvrti ad Moenum, apud Georgium Coruinum, impensis Sigismundi Feyerabent
M. D. LXXIIII.

Eine von Goedeke (siehe Anm. 4) angegebene (S. 417 No. 16) Ausgabe: “Frkf.
Sigm. Feyrabend. 1580. 4° (nach Angabe in Clessii ** Elenchus consummatissimis

♦ Ich land auch die Namensschreibung; Paul Reffeler. Siehe auch: Heinrich Pallmann;
Sigismund Feyerabend. In: Archiv f. Frankfurter Geschichte und Kunst. 1881. Vol. VII.

♦♦ Cless, Johann: Unius seculi, eiusque virorum literatorum monumentis . . . Franco¬
furti 1602. Vol. 2; Catalogus librorum Germanicorum.

DER ZAHNBRECHER DES HANS SACHS 277

sind zu den Amman’schen Holzschnitten vier Verse iiber, sechs unter
jede Darstellung gesetzt, nicht Reimverse in der Art des Hans Sachs,
sondem je 5 lateinische Distichen. Die als Oberschrift gegebene Berufs-
oder Standesbezeichnung ist^* deutsch und lateinisch gehalten. Dass
Hans Sachs infolge seiner Verbindung mit dem Feyerabend’schen Verlage
die lateinischen Verse des Schopper gekannt hat, ist sicher, dass er aber,
wie oft gesagt worden ist, diese Verse einfach ins Deutsche iibersetzt
habe, wird schon durch einen nur oberflachlich vorgenommenen Vergleich
widerlegt. Seine inhaltlich und formal meisterhaft in acht kurze Reime
cwnprimierten Bildunterschriften sind vollig unabhangige Dichtungen,
die, selbst ausserlich, durch die fiir sie verwendete Frakturtype zu den
kraftigen Holzschnitten Amman’s wesentlich besser passen als die zier-
lichen, in diinner Cursivschrift (italic) gehaltenen lateinischen Distichen
des Hartmann Schopper. Bild und Text bilden in den deutschen Ausgaben
in jeder Beziehung eine Einheit und geben mit knappsten Mitteln auf
engstem Raume ein naturgetreues Bild des Zahnbrechers der Renaissance.

Die Amman’sche Darstellung des umherziehenden Zahnbrechers. und
init ihr die iibrigen, nicht sehr zahlreichen, im sechzehnten Jahrhimdert
entstandenen Holzschnitte und Kupferstiche, die dasselbe Thema be-
handeln,** sind die wesentlichste Quelle fiir unsere Kenntnis von diesem
einen Aste des vielverzweigten Stammbaumes heutiger Zahnarzte. Aber
alle diese Bilder, und mit ihnen der Sachs’sche Schwank, lassen die bisher
unbeachtet gebliebene kultur- und medicohistorisch wichtige Tatsache
erkennen, dass zu jener Zeit die spater in so buntschillernden Farben und
Formen in die Erscheinung tretenden Auswuchse im offentlichen Auf-

librorum . . . Francof. 1602. 2,277) ” existiert nach meinen Feststellungen nicht. Ebenso
muss Goedeke’s Angabe unrichtig sdn, dass die deutschen Ausgaben “ eigentlich eine
dcutsche Ausgabe von Hartmann Schopper’s Panhoplia, omnium illiberalium . .. Francof.
{$64 und 1568 ” sind. Goeddce nimmt namlich mit Meinecke (Diet. I. 218) und Heinekken
(No. 2) an, dass bereits im Jahre 1564 die erste lateinische Ausgabe erschienen ist, die
dann allerdings als die iiberhaupt erste Ausgabe des Standebuches anzusprechen ware.
Abgesehen davon, dass ich einen derartigen Druck nirgends hnden konnte, kann eine
t’or 1568 gedruckte Ausgabe gamicht herausgekommen sein, da auf dem Titelblatte der
Ausgabe von 1568, also der gleichzeitig mit der deutschen Ausgabe erschienenen latei¬
nischen Ausgabe zu lesen ist: “. . . imagines . . . antehac nec visae, nec unquam editae.”
Hier ist also nicht nur. wie auf dem deutschen Xitel vermerkt: “deren gleichen zuvor
tiiemands gesehen,” sondern, daruber hinausgehend, sogar: “. . . noch niemals vorher
herausgegeben.”

” In der Reihe der Berufsdarstellungen befinden sich auch die hier besonders interes-
sierenden Holzschnitte: No. 11: Der Doctor. No. 12: Der Apotecker. No. 51: Der
Ralbierer (Abgeb. bei: Proskauer, Curt: Iconographia Odontologica. Berlin 1926 Abb.
17) No. 52: Der Zanbrecher. No. 53: Der Bader.

“Proskauer, Curt: Iconographia Odontologica. Abb. 10, 11, 13, 14, 16, 18, 20, 22, 23.

278

CURT PROSKAUER

treten der Zahnbrecher — entgegen der bisherigen Anschauung — noch
gamicht vorhanden waren. Fiir diese Annahme spricht auch das Fehlen
jeglichen Hinweises auf derartige Missstande in den zeitgenossischen
textlichen Quellen, besonders in den amtlichen Dokumenten, in denen sic
naturgemass am ehesten—wie spater im siebzehnten und achtzehnten
Jahrhundert stets — zu finden sein miissten, wenn solche Zustande tat-
sachlich bestanden batten. Nicht auf einem einzigen Blatte des ganzen
sechzehnten Jahrhunderts — Darstellungen fahrender Zahnbrecher aus
noch friiherer Zeit sind nicht bekannt — sieht man die spater in der
Begleitung der Zahnkiinstler fast niemals fehlenden Gaukler, Seiltanzer,
Possenreisser und Harlekine, die auf erhohtem Podium ihre Narren-
possen trieben und von der Biihne herab durch Geschrei, Blasen vwi
Trompeten und durch Trommellarm das neugierig gewordene Publikum
aniockten. Alle diese Zahnbrecher sind noch ohne den spater iiblichen
theatralischen Aufputz, der einen besonderen Nimbus verbreiten sollte,
dargestellt. Auf einem einfachen Tische breiten sie ihr Handwerkszeug
sowie ihre Flaschen, Salbendosen und Elixiere aus, die sie neben ihrer
Haupttatigkeit, dem Zahnausziehen—dem Publikum verkaufen. An einer
am Tische befestigten Stange hangt ein diplomartiges Dokument, das die
Arbeitserlaubnis fur die Zeit der Markt-oder Kirchweihtage bescheinigt,
dariiber primitiv gemalte grosse Plakate, wie sie die Bankelsanger vor
ihren Zuschauern aufrollen, dem Publikum das vielseitige Betatigungsfeld
des Zahnbrechers in grellen Farben augenfallig prasentierend.^* Der
Zahnbrecher dieser Epoche macht, was das Aussere seines Auftretens
anbelangt, einen durchaus soliden Eindruck. Das andert sich erst mit
dem Beginn des neuen Jahrhunderts, dessen Kunststil als Barock be-
zeichnet wird, ein Begriff, den der Sprachgebrauch von der kiinstlerischen
Form auf das Leben und die Lebensausserimgen selbst ubertragen hat
und unter barock alles Bizarre versteht. Barock ist das Sonderbare im
Betragen, das mit Absicht von den geltenden Normen abweicht, es ist
das Groteske, das Extravagante, es ist die Sucht nach dem Auffallenden
und Seltsamen, das; mitunter durch den Reiz des Geheimnisvollen fesselt.
Diese fiir das Wort “ barock ” iibliche Definition konnte geradezu wort-
lich zur Charakterisierung des Aussehens und des Gebarens der umher-
ziehenden Zahnbrecher, wie sie die zahllosen Gemalde und graphischen

“Der Amman’sche Zahnbrecher-Holzschnitt ist von dem die Vorlage copierenden
Holzschneider im Gegensinne, kehrseitig, wiedergegeben worden, sodass der Zahnbrecher
in alien vier Ausgaben mit der linken Hand den Zahn ziehend dargestellt ist. Die auf dem
Tisch knauelartig zusammengeringelten Schlangen gehdren ebenfalls zu den Requisiten
des Zahnbrechers, da deren Giftausscheidungen angeblich zur Bereitung des kostbaren
Theriaks benotigt wurden.

DER ZAHNBRECHER DES HANS SACHS 279

Blatter des 17. und 18. Jahrhunderts schildern, herangezogen werden.
Und es scheint mir kein Zufall zu sein, dass der Beginn des barocken
Auftretens der Zahnbrecher seitlich mit dent Beginn des Barocks zusam-
menfallt, aber auch kein Zufall mehr, dass die bildenden Kiinstler jener
Zeit mit besonderer Vorliebe gerade die bizarre Gestalt des Zahnbrechers
als Modell fiir ihr Kunstschaffen gewahlt haben: das Bizarre hatte seinen
Einzug in die Kunst gehalten, die immer der Spiegel, die Chronik ihrer
Epoche ist. Die Kiinstler mogen in diesen barocken Figuren der Zahn-
brecher also nicht nur, wie immer gesagt worden ist, den Reiz des
Malerischen und Volkstumlichen gesehen, sondem, wenn auch vielleicht
nur unterbewusst, geradezu den verkorperten Ausdruck des Stiles ihrer
Zeit entdeckt haben.

]5itkvin vnb dme UgtnbmiTM;

ten vntcr/gtcn 3411^

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BECCARIA

(173&-94)

GEORGE SARTON

In 1764, there was published anonymously and clandestinely a modest
little volume entitled Dei delitti e delle pene which was destined to awaken
the conscience of men as few books ever did. So much so that its appear¬
ance is a landmark in the history of humanity. One might wait until 1964
in order to celebrate its second centenary, but why should we wait that
long? Indeed, the time to celebrate the battles won for the sake of freedom
is right now when freedom is jeopardized in such a large part of the world.

The author of that little book was Cesare Bonesana Beccaria, then a
young man of twenty-six. He was born in Milano on March 15, 1738
and spent the whole of his life in that city, but we could not call him a
citizen of Milano, for there were no citizens in Milano or in Lombardy,
but only subjects—Austrian subjects. Cesare was the son of Gian Saverio
Bonesana, Marchese di Beccaria, and of Donna Maria Visconti da Rho.
He was educated in the Collegio dei nobili of Parma directed by the
Jesuits and obtained a law degree in the University of Pavia in 1758.
In spite of his family’s opposition, he married Teresa Blasco^ and his
father stopped his allowance for a while. Milano being asleep under
Austrian despotism was not a very stimulating place to live in. There
were some 120,000 inhabitants but hardly twenty (said Beccaria) took
any interest in disinterested ideas. Happily, foreign books were not kept
out, as they were in Spain, and the young man could satisfy his intellectual
hunger. We know exactly what happened to him, because he explained
it in a letter to the Abbe Morellet, dated May 1766, when the struggles
of his adolescence were still close enough to be remembered without
deformation.* French books, especially the “immortal” Encyclopedie,
had developed in his soul the humane feelings which had been smothered
during eight years of a fanatical education (these are his own words).
His mind had been aroused c. 1761 by the Lettres persanes (1721), then
more furiously by Helvetius’ Esprit (1758), a book which had scandalized

* The daughter of a lieutenant colonel, she was of plebeian birth and had no dowry.

* These letters to Morellet have been printed in many editions. I read them in the
French one by Collin de Plancy (Paris 1823).

283

284

GEORGE SARTON

its readers and set them by the ears. It would have been unfortunate, if
young Beccaria had been obliged to digest that pabulum all by himself,
for intellectual food needs discussion to be properly assimilated. Happily
for him he was admitted in the little group which gathered around the
Verri family. The father, Conte Gabriele Verri (1696-1782), a jurist
and one of the highest magistrates of the city, was still living, but being
a hard and intolerant man he had failed to conciliate his own sons, had
cut them off, and they had set up a separate establishment, very modest.
Being himself in disgrace, Beccaria joined the Verri brothers, Pietro
(1728-97), Alessandro (1741-1816), and Carlo (1743-1823). The first
of these was primarily an economist, and a very distinguished one, a prede¬
cessor of Adam Smith,® and Carlo, an agronomist, while Alessandro was
a man of letters.* In a way they were all men of letters, but Alessandro
lacked the scientific interests which moved the others; they were medi¬
tative and studious men, open-minded, careful readers of the Encyclopedic
as each volume of it appeared, trying to be as well informed as possible,
exercising themselves to think without prejudices and to express their
thoughts clearly and beautifully. The Verri cenacle was an island of
freedom in Milano; Beccaria’s admission into it was his salvation, it pre¬
vented him from feeling that he was an exile in his own country. Having
been advised by his friends and especially by Pietro—ten years older than
himself, his chief mentor—to investigate tangible questions, his first study
concerned the monetary situation which was then very involved.® He took
part in the redaction of II caffd, a journal which the brothers Verri had
initiated, more or less in imitation of Addison’s Spectator. It was a very
distinguished periodical appearing every ten days; unfortunately, it lasted
only two years (June 1764 to June 1766).® We may assume that it
reflects the conversations which took place in the Verri circle and hence

*Four or five Italian editions of his little but important work Meditasioni sulla eco-
nomia politico appeared in 1771; a French translation, in Lausanne 1773, a German one,
in Dresden 1774. The Wealth of Nations was published in March 1776. Adam Smith
knew of Verri’s views either directly or through Condillac.

* It is possible that Alessandro Verri is known to more Italian readers than the other
members of the family, but the greatest of them all was Pietro Verri. Carlo did not
really belong to the group of which Pietro and Alessandro were the animators.

^ Del disordine e dei rimed) delle monete nello stato di Milano nel 1762 (Lucca 1762).

* The original edition was printed in Brescia just outside of the Stato milanese, yet it
circulated openly in Milano. The two volumes were reprinted almost immediately in
Venezia 1766 (fig. 3) ; then again in Milano 1804. I have seen only the two reprints.
The title-page (which we reproduce, fig. 2) and first page of the original are included in
Valeri (1937). On account of the existence of that journal the Verri group was often
called “ Societa del caffe.” It was also called, rather incongruously, “ Accademia dei
pugni.”

Beccaria’s portrait, 1766.
(Civica raccolta delle stampe, Milano)

286

GEORr.E SARTON

can form some idea of these. The articles of both volumes are divided
under the following headings: sulla legislazione ed economia pubblica;
della morale e del cuor umano; agricoltura, storia naturale e medicina;
di varia letteratura. It is clear that the discussions were not restricted to
literary subjects; on the contrary, they were largely devoted to economical.
]»olitical and s(x:ial questions (religious issues w'ere avoided). The group
mcluded two mathematicians. Count Luigi Lambertenghi and the more
famous Paolo Frisi (1728-84), Barnabite. friend of d’Alembert; Beccaria
and Pietro Verri were also mathematically minded. Their “ encyclo-
pedisme” w-as moderate; they were more outspoken in purely literarj'
matters, denouncing academic pedantism and especially the archaeologic
and fossilizing tendencies of the Accademia della Crusca. They avoided
abstractions, training themselves to think in concrete economic terms
(which are to some extent scientific terms); that was their originality in
their time and place. Ales.sandro was a protector of prisoners (protettore
(lei carcerati). which I take to mean that he visited prisoners and that
the cases of iH)or defendants were intrusted to him for pro Deo pleadings.
Thus Ales.sandro, and through him the whole cenacolo, was familiar
enough with the mi.series springing out of arbitrary and despotic justice.
There was an outstanding example of such "justice” which nobcnly in
Milano could then forget, for it w’as celebrated by a public monument,
a column of infamy. At the time of the great plague of 1630 a dozen men
had been tortured to death because they had been accused of having
deliberately spread the i)lague by the use of ointments. One of the men
accu.sed of that infernal crime was a barber; his shop had been razed and
the “colonna infame" erected in August 1630 to mark the accursed
ground. The “colonna” was surreptitiously caused to fall down in 1788
and not rebuilt. Indeed, it had not answered its purpose. Built to }x;r-
petuate an imaginary crime, to many people it per|)etuated only a real
judgment. The infamous deeds which the “ colonna ” recalled were not
those imjmted to imuKents but those i)erpetrated by their judges.^
Another example more distant in space but nearer in time must have
greatly excited the Verri group. I am now referring to the "cause
celebre ” of those days, the judicial murder of Jean Calas in 1762.
Voltaire sheltered the widow and two children of the unfortunate and
devoted three years to their rehabilitation. Thanks to his efforts Calas’
memory was vindicated in 1765.’* But we are running ahead of our .story.

^ See Appendi.x 1.

" When we are tempted to s|>eak ill of Voltaire because of his greediness, scepticism,
cynicism, etc., we should think of Calas That was the outstanding good deed of his life.

BECCARIA

287

At the time immediately preceding the publication of Beccaria’s famous
book Galas was dead and his family hopelessly ruined and dishonored.
Voltaire was moving heaven and earth to reestablish their good name,
and we may be sure that all the “ encyclopedistes ” of France and Italy,
not to forget the little Milano group, were fighting with him as much as
they could or dared. In most cases they could do very little without
ninning—in vain—^terrible risks. Moreover, miscarriages of justice were
so frequent that most people took them for granted, as a part of man’s
fate, and hardly dared discuss them even behind closed doors. Of course,
much whispering was done by the relatives of the victims, but it is probable
that the Verri apartment was then the only one in Milano where such
matters could be discussed in a general way down to the roots.

This explains the genesis of the book on crimes and punishments which
immortalized Beccaria’s name. He began the redaction of it in March
1763 and completed it in January 1764. The book was written in the
Verri apartment, with the encouragement and collaboration of the two
Verri brothers, chiefly Pietro, The latter was the initiator and moving
spirit, he knew how to stimulate his young friend and shake him out of
his natural indolence, he gave him the necessary documents, discussed
with him each chapter as it was completed and then made a fair copy of
it in his own hand. It was he also who saw the book through the press
and read the proofs. Nevertheless, Beccaria must be called the author of
the book; the Verri brothers themselves never denied his authorship even
when they were on bad terms with him.

As the author and his friends realized the need of precaution, the book
was printed clandestinely, not in Milano nor even in Lombardy but in the
grand duchy of Tuscany. The printing was done with so much secrecy
that even as late as 1821 Cesare’s son, Giulio, still believed that it had
been done in Monaco, It is now generally admitted that it was done in
Livorno (Leghorn). As we shall see presently the book obtained at once
considerable success, and in spite of the efforts of Father Ferdinando
Facchinei,® a monk of Vallombroso, to prove that Beccaria was guilty of
irreligion and lese-majeste, the author was not persecuted. This was largely
due to the fact that the imperial governor of Lombardy, Count Charles
Firmian (1716-82), was, all things considered, singularly enlightened
iind benevolent. When the book was endangered by Facchinei’s malice.
Count Firmian himself wrote to the court of Vienna to say that it did

and because of it he deserves our gratitude. Voltaire used his prestige to defend other
innocents, but the “ affaire Calas ” is the best remembered.

* Note ed osservasioni sul libro intitolato Dei.delitti e delle pene (192 p.* s. 1. 1765).

288

GEORGE SARTON

honor to its author. He was a “ grand seigneur ” who protected Beccaria;
his generosity has been amply rewarded, for it is now the latter who
protects him from oblivion; he will always be remembered as the friend
of Beccaria.

Thanks to Firmian’s patronage, Beccaria was appointed in 1768 pro¬
fessor of “scienze camerali” in the “scuole palatine” of Milano. He
became a member, in 1771, of the supreme economic council, and in 1791,
of the giunta for legal reform. It is not true to say that he was the first
Italian teacher of political economy; he had at least one great predecessor,
Antonio Genovesi^® (1712-69), whom he himself called the father of
political economy in Italy. His own lessons were published only ten years
after his death.” It is interesting to note that even as he had begun his
career with a memoir on the reform of currency he ended it with another
on the reform of measures. In this paper of his dated 1780,” he explained
the advantages of a decimal metrology (being one of the first to do so
after Stevin) and the merit of a standard of length derived from geodetic
measurements. The standard which he suggested—the length of a minute
of latitude in the parallel of Milano—^had the drawback of being a function
ot a definite latitude (the length of the second pendulum was open to the
same criticism), yet it was less arbitrary than the old units. The two
ideas realized (1791-95) by the French Revolution—decimalization and
imiversal standard—^were thus foreshadowed by Beccaria. This illustrates
his scientific turn of mind. His approach to monetary and metrological
questions was that of a physicist rather than, of a rhetorician.^*

Beccaria was twice married. The wife of his youth, Teresa Blasco, gave
him two daughters, Giulia and Maria; she died in 1774 and he promptly
married Anna, Contessina Barnaba Barbo, by whom he had his only son
Giulio. The Marchese Giulio Beccaria established a kind of museum in

Of Castiglione dei Genovesi in the Salerno district. He taught in Naples.

" Element! di economia pubblica {Scrittori italiani di economia politico, vols. 18-19,
Milano 1804).

Delle riduzione delle misure di lunghezza all’ uniformita per lo stato di Milano.
Relazione presentata al magistrate camerale il XV gennaio MDCCLXXX (Scrittori
Hal. di econ. pol., vol. 19. 243-313, Milano 1804).

For comparison, see Guillaume Bigourdan; Le systime metrique des poids et mesures
(Paris 1901). C. D. Heilman: Jefferson’s efforts towards the decimalization of U. S.
weights and measures {Isis 16, 266-314, 2 pi., 1931). G. Sarton: Stevin (.Isis 21, 241-
303 ; 23, 153-244, many facs. 1934-35).

“ Our calling him “ a physicist ” might increase the confusion with his contemporary
namesake Giovanni Battista Beccaria (1716-81), geodesist and electrician, friend of
Franklin. These two Beccaria were unrelated. Father Beccaria, the electrician, was a
scolopio (a clerk regular of the pious schools) and Piemontese. He spent most of his life
in Torino and died there.

BECCARIA

289

his house and made a collection of all the editions and translations of his
father’s book. As to the daughters, I do not know what happened to
Maria, but I suspect that she died young, for some biographies speak of
only one daughter, Giulia, who married Don Pietro Manzoni and gave
birth in 1785 to a son, Alessandro. The ten last years of Cesare Beccaria’s
life were brightened by the presence of that little boy, but the happy
grandfather could not foresee that this boy would become one of the
glories of Italy. Alessandro Manzoni (1785-1873), conservative as he
was, would continue the defense of justice which Beccaria had begun.

Please note that Cesare Beccaria gave the world two great books, the
first directly (with a little help from the Verri )—Dei delitti e delle pene
(1764), the second indirectly via Teresa Blasco (who had not been thought
worthy of entering the noble Beccaria family), Giulia, and Alessandro—
/ promessi sposi (1827). Without him neither of these books would
exist. He may be called the father of the former and the great-grandfather
of the latter.

He died of apoplexy in his native city on November 28, 1794, at the
age of fifty-six.

The essay on crime and punishments was an attempt to establish
criminal justice on a rational basis, reducing penal laws and procedure
to some kind of uniformity, eliminating as much as possible every cause
of arbitrariness. Beccaria explained the need of separating the legislative
from the judicial function. He discussed the origins of punishment, the
right to punish and its restrictions. Punishment should not be in the
nature of a vengeance, it should never imply torture or ill faith. Beccaria
and his circle were very well informed on inquisitorial procedure, not
only from their reading (e. g., they probably knew Eymeric’s Directorium
or its French summary by the Abbe Morellet) but from their own experi¬
ence. He spoke but little of that, for it was not necessary; everybody
knew enough of it and could be trusted to read the book in the light of
that hidden knowledge. Justice, he said, should not be a means of enrich¬
ing the prince or the judge. Confiscation of the property of accused
persons, or even of guilty ones, is wrong, for it penalizes innocent families
and may cause new crimes. Punishment should never be extended to the
relatives or friends of those proved to be guilty. There should be no
.secrecy in the accusations or in the criminal procedure. The defendant
should know exactly what the charges against him are; the people wit¬
nessing against him should be brought face to face with him; he should
be deemed innocent as long as his culpability was unproved and be given

Fig. 2.

II caffi.

T*itle-i»«Lflre of first vottime. orisinat edition, Brescia 1765.

I L CAFFE

O S I A

• %

BREVI E YAK} DISCORSI
GIA- DISTRIBUrri IN FOGLI PERlODfCI
SECONDA EDIZIONE
TOM O-P R I M O.

IN VENEZIA

MOCCLXVI.

Appresso Pietro Pizzolato

Con Licenza dc’ Snperiori , e Frivile^io ..

Si vende alia Libreria della Coftansa.

Fig. 3.

II caffi.

Title-page of first volume. Contemporary reprint, Venice 1766.
(Mew Enirland Oeposit Library, Boston)

BECCARIA

291

every possibility of vindicating himself. The penalties should be pro¬
portioned to the offenses, they should be public, certain and prompt, but
not harder than could be helped;^* it was better to err on the side of
clemency than on that of rigor; the penalty of death is excessive and
unnecessary. In many cases the judge should be assisted by a jury care¬
fully chosen with a view to impartiality. The accused and even those who
have been convicted of guilt are human beings and should he treated as
.^uch.

This rapid enumeration of its main points does not give a sufficient idea
of this little book, so full of experience and wisdom, rational and sensible,
informed throughout with gentleness and mercy. Every reader appre¬
ciated its deep humanity, even the princes and governors, everybody except
the good father Facchinei.^*

During the nineteenth century Beccaria’s views were so completely
realized that at the end of it they looked like platitudes and it required
some effort of imagination to understand their boldness. Beccaria’s pur¬
pose had been to put an end to the criminal maladministration of justice
which the tribunals of the Inquisition had introduced and developed with
increasing ferocity and ill-faith during the Middle Ages. At the time of
his writing the Inquisition was still flourishing in many countries, and
where it had been suppressed its methods had not yet been eradicated.
Judicial torture was resorted to in Milano until 1789. Hence what
Beccaria did was not only necessary, but bold and dangerous. He knew
it and his friends knew it, and but for the protection of Count Firmian
he would have been persecuted.

The intrinsic boldness of Beccaria’s book may easily be overlooked
because of the very moderation and quietness of his statements. There
was in it no swashbuckling or stridency of any kind in spite of the fact
that no generous soul could think of the conditions obtaining in Lombardy
and other countries (remember Galas!) without boiling with anger. Not

“ See the final § of his book which we reproduce from the princeps.

“ It is amusing to pass from the serene atmosphere of Beccaria’s book to the Note ed
osservasioni of the good father. He calls Beccaria in various places “ un uomo di mente
angusta e limitata,” “ frenetico,” “ impostore,” “ ingannatore del pubblico,” “ che non sa
quel che si dica,” “ che fa stomaco,” “ pieno di velenosa amarezza, di calunniosa morda-
cita, di perfida dissimulazione, di maligna oscurita, di vergognose contraddizioni,” “di
sofismi, cavillazioni e paralogismi.” The book is described as an “ opera sortita dal piu
profondo abisso delle tenebre, orribile, mostruosa, plena di veleno,” etc,, “ e che sorpassa
la misura della piu maligna e piu sfrenata satira. etc.’’ It is well that the good father
was in a peaceable mood when he wrote his animadversions (comincio tranquillamente
le mie note e le mie riflessioni . . . ) ; one wonders what kind of language he would have
used if he had not been so benign.

292

GEORGE SARTON

only was Beccaria very temperate but he was sometimes a bit unclear,
trusting that the readers would read between the lines. Where oppression
exists people get used to speak in a sibylline manner when they have
something important to say, they learn to catch on at once to what is said,
they are trained in the art of making hints and taking them. Beccaria
was timid but not pusillanimous. In a letter to Morellet (1766) he
remarked, “ I have kept in mind while writing the examples of Machiavelli,
Galileo and Giannone.” I have heard the noise of chains which supersti¬
tion is shaking and the cries of fanaticism smothering the moanings of
truth. The sight of that terrific spectacle has led me sometimes to wrap
up the light in clouds. I have wanted to defend mankind without becoming
a martyr.” His candor is disarming. Moreover, his mildness was more
apparent than real; he was not afraid of thinking through. For example,
speaking of thieves he remarked quietly that the right of ownership is a
terrible and perhaps unnecessary one.^* In the early editions he had sug¬
gested that a merchant who went bankrupt (even without fraudulency)
might be detained and obliged to work for his creditors. Later he retracted
this and added sadly “ I am ashamed of having been able to write
anything so cruel. I have been accused of impiety and sedition, though
I am neither seditious nor impious. I have offended the rights of mankind
and nobody has stood up against me.”

This is transparent to me. It reveals Beccaria’s profound honesty and
the reality of his courage. It is true that having won a great battle in his
youth, he did not engage in new ones. This may have been due to his
native indolence, to his domestication by the kind and clever count Firmian,
or to the torpor wherein his country was plunged. At any rate that single
book, the single battle which he won without bloodshed, is sufficient to
immortalize his name and to insure to him the gratitude of posterity.

Ill

The immense success of the Delitti e pene is the best proof of the book’s
timeliness. The essential injustice of criminal laws and procedure must
have been realized not only by him but by every person who was either
honest or intelligent. If the person was both honest and intelligent the

Antonio Giannone of Naples (1787-1823) was a fighter for independence who died
on the scaffold.

** (§ XXX. Furti) . . . il delitto di quella infelice parte di uomini a cui il diretto di pro-
prieta (terribile e forse non necessario diritto) non ha lasciato che una nuda esistenza ...

** (§ XXXII. Dei debitori). “Ho vergogna di avere scritto cosi. Sono stato accusato
d’irreligione, e non lo meritava. Sono stato accusato di sedizione, e non lo meritava.
Ho offeso i diritti dell’ umanita, e nessuno me ne ha fatto rimprovero I

r--

BECCARIA 293

realization must lead to protest, yet it took the gentle courage of a Beccaria
to voice that protest publicly and to cause it to be shouted frcmi the
housetops of the world.

The first edition of his book appeared in Livorno in 1764, six Italian
editions within eighteen months, at least nine within ten years, at least
nineteen within the author’s lifetime. In Rome, the book was seized with
avidity even by people whose literary commerce was restricted to the
almanac.*® It was quickly known abroad, especially in Paris, which
became its real center of dispersion. That noble magistrate Lamoignon
de Malesherbes (1721-94) had seen at once its importance and persuaded
.\ndre Morellet (1727-1819) to undertake a French version of it. Morellet
translated the book promptly, clarifying a few points here and there and
improving its order. The French text appeared in Philadelphia (i. e.,
Paris) in 1766. This text was even more popular than the original one,
for it reached a public which was considerably larger and more alert.
There were at least five French editions within the year 1766, at least
eight within Beccaria’s lifetime. The book was immediately praised by
such men as Diderot, Helvetius, Buffon, Rousseau, Hume, Holbach,
d’Alembert. The Abbe Morellet, by the way, was well prepared for his
task. He was one of the collaborators of the Encyclopedie and Voltaire
thought well of him, writing in 1760, “ Embrassez pour moi I’abbe Mords-
les. Je ne connais personne qui soit plus capable de rendre service a la
raison” (NBG 36, 533-37, 1861). The Abbe had stumbled in Rome
upon a copy of Nicholas Eymeric’s Directorium inquisitorum and had
summarized it in French (Lisbon 1762), his idea being that the best way
to fight the Inquisition was to show it as it was. His subsequent imprison¬
ment for two months in the Bastille had increased his prestige among the
“ jAilosophes.”

The opposition to Beccaria was just sufficient to enhance his popularity.
We have already referred to the charitable animadversions of Father
Facchinei (1765). As soon as these were known, Pietro and Alessandro
Verri set to prepare a refutation and worked with such passion that their
Risposta^^ was written and printed(?) within five days. It was written

** “ Posso dire che anche il ceto delle persone meno curiose di letterarie notizie, come
sono i cardinal! ed i prelati, conoscono t Delitti e le Pene. lo'credo che chiunque legge
soltanto il lunario ha notizia di quest’ opera ” (Letter from Alessandro Verri to his
brother Pietro, dated Rome. July 26, 1780, quoted in Beccaria’s Opere, vol. 1, p. xlvii,
Milano 1821).

Risposta ad uno scritto che s’intitola Note ed osservcuioni sul libro Dei delitti e delle
pene (Lugano 1765). I have not seen the original, but a reprint in the edition of Dei
delitti e delle Pene, with kindred writings (4 small vols. 14 cm., Bassano 1797). It is in
vol. 2. p. 3-102.

Ci i/t f ^

JD JE a: T> M X. X •r T X

DELLE pene.

In rehus quUmfcumque difficilloriitu non expeSan-
dum^ Ut quit pmut, & feral, & metal, fed
praeparaiione opus efl, ut per gradus mature-
fcant. Bacon. Scrm. (idcl. num. xlv.

MDCCLXIV.

Fig. 4.

First editioa Livorno 1764.
(Harvard Law Library)

104

lazione tra 1 oggetto* e la fenfazione. A mifu-
ra che le pene divengono piii dolci, la cle>
incnza, ed il perdono diventano meno nccefla^
ij: Felice U Nazione, nella quale farebbcro fu-
nedil

Da quanto fi ^ vcduto finora pu6 cavarPi
un Teorema generale molto utile, ma poco con-
forme alfufo, Legiflatore il piii ordinario del*
le Nazioni, cio^ s perebi ogni pena non pa vna
violenza di uno , 0 di mold contro vn privato Cit-
tadiao, dev'ejfere ejfenzialmente pubblica, protu
ta , ttecejfaria , la ntininia dellepopibili nelfe date
circoPanze , proporzionata at delitd , dettata dal-
Is Leggi.

FINE.

Fig. S.

Last page of first edition, Livorno 1764.
(Note the conclusion in italics)

294

GEORGE SARTON

anonymously in Beccaria’s name, but by them; the lazy Beccaria would
never have been capable of such speed. Some people who were jealous of
his success accused him of having obtained his ideas from French sources.
That was partly true but what of it ? Beccaria acknowledged his indebted¬
ness as generously as the French leaders of opinion recognized the
originality and the merit of his effort. They were very anxious indeed
to recognize it.

In 1766, he was invited to go to Paris, in order to receive the homage
of his admirers. He left Milano with Alessandro Verri on October 2,
with the intention of spending five or six months abroad. When he was
only thirty miles out of the city he wanted to return, and when he arrived
in Lyon his homesickness was extreme. He kept worrying about his wife,
his children, his friends, and but for Alessandro’s persistence he would
have gone back post haste to Milano. This gives us a new insight into
his timidity, which was such that he would have preferred to hide himself
rather than be the lion of the season in Paris. However, the two friends
arrived there on October 18 and were much feted everywhere, “ Beccaria
in ogni luogo e accolto con adorazione ” wrote Alessandro to his brother.
Yet our hero could not stand that sort of thing very long; the thought of
his family and of his country obsessed him and he suddenly decided to
leave Paris and to return home via Ferney, where he stopped to pay his
compliments to Voltaire. “ Chi mai avrebbe potuto prevedere simile
pusillanimita nel vigoroso autore dei Delitti e delle Penel”, exclaimed
Pietro Verri. The word pusillanimata was too strong; timidita would
have been more correct, though a medical term would probably be needed
to fit the case exactly. It is a curious paradox that this man who helped
us to accomplish one of the deepest reforms, who approved himself one of
our liberators, was so indolent and timid that maybe he would have
accomplished nothing without the prods of his friends. We may add that
his success was partly due to his timidity and moderation which disarmed
his enemies. Alessandro Verri was more adventurous; he continued his
journey to London and then went to Rome where he spent the rest of
his life. Beccaria arrived in Milano on December 12. He had been
absent altogether two months (instead of six), a good part of which was
consumed in travelling.

The Parisian success and the praise of the Encyclopedistes excited the
interest of Ekaterina II, who tried to attach Beccaria to her service.
Count Firmian advised Maria Theresa to give him permission to go but
only for a limited time (Beccaria did not go to Russia). It is amusing
to observe the two autocratic women equally concerned to enlist the

296

GEORGE SARTON

collaboration of the great liberal philosopher. What is more important,
Beccaria’s views were taken into account in the redaction of the Russian
code, and a Russian translation of his book was published by imperial
order in St. Petersburg in 1803. In the meanwhile, the book had been
translated into English, German, Dutch, Spanish, and Greek and the whole
world could read it. It is significant that it was not translated into Latin
which would have been the case if it had appeared half a century earlier.
By now Latin had ceased to be an international language of sufficient
currency, and hence to make the book available to the civilized world it
had been necessary to prepare seven translations of it instead of one.

Beccaria is an outstanding figure in the history of law, but our readers
might object and say “ What has that to do with the history of science?”
The answer is easy. It has very much to do, it has everything to do with
the history of science. Science implies freedom and Beccaria fought and
for a time won one of the greatest battles for freedom.”

This may fail to satisfy the inquisitive reader who insists “ Was there
then no science before Beccaria?” Of course, there was,—plenty of it.
In a sense, we might almost say that the essential had already been done.
Science began just as soon as man stopped to think and asked himself
questions. It began in the garden of Eden. The invention of the first
wheel required more genius than that of the latest dynamo. The birth of
a man of genius is unpredictable; it may occur at the most inappropriate
time and in the most dismal surroundings. However, the development of
that genius may be hindered or smothered by adverse circumstances, even
as it may be helped immeasurably by favorable ones. The improvement
of those circumstances is thus extremely important.

Moreover, the history of science is not simply an account of inventions
and discoveries. We are deeply interested in the diffusion of scientific
knowledge and even more so in the diffusion of the scientific spirit, and
that diffusion implies freedom and justice.

We need not discuss these matters in the abstract, for decisive experi¬
ments have been made on a large scale. Compare the history of science in
Spain with its history in France and England. Spaniards were just as
intelligent as Frenchmen and Englishmen, but they were blighted by the

** For the most recent aspects of that question, see Sir Richard Gregory: The common¬
wealth of sdence (Isis, 34, 27, 1942). Chauncey D. Leake: Science implies freedom
(Studies in the history of culture, 310-20, 1942).

BECCARIA 297

Inquisition** while their rivals enjoyed a modicum of freedom. The
results are there for everybody to see, and Spain is not yet cured from
the poison which was injected into its people for so many generations.
Spain has not yet learned the habits of freedom, tolerance, and mercy.

Beccaria was deeply aware of the necessity of scientific knowledge to
insure freedom, and vice versa of the need of freedom for the blossoming
of science. The main concern of law, he claimed repeatedly, was to prevent
crimes rather than punish them. His penultimate chapter is devoted more
especially to that very question. And one of the answers was “ Volete
prevenire i delitti? Fate che i lumi accompagnino la liberta. I mali che
nascono dalle cognizioni sono in razione inversa della loro diffusione;
e i beni lo sono nella diretta.” That chapter is an admirable defense of
science from the social point of view; it illustrates beautifully the scientific
spirit of the author and reveals him as a forerunner of Quetelet.

During the nineteenth century the reforms, the need of which had been
so quietly and so convincingly explained by Beccaria, had been so much
generalized that they were taken for granted and that his merit was in
danger of being forgotten. To be sure there were still miscarriages of
justice, for legal institutions participate like every other of human weak¬
nesses, but when a miscarriage occurred the whole world was up in arms.
The main ideas had prevailed. The accused had to be considered innocent
as long as their guilt was unproved, they were to be treated with humanity
and decency, every means should be given them to vindicate themselves.
This was so well understood that the great American historian, Henry
Charles Lea (1825-1909), could indulge in a certain amount of optimism.
His history of the Inquisition and of other cruel institutions of the past
had been written with the objectivity of an anatomist. Terrible as it was
that story was bearable, because he himself and every reader realized that
those horrors were past and gone. In spite of Lea’s detailed, exact and
candid study of their thoughts and deeds, the inquisitors were becoming
so distant that one would forgive and almost forget their crimes. They
were past and dead and the children of men could breathe the air of
freedom without fear.

To illustrate Lea’s pardonable optimism let me quote the conclusion of
his earliest book. Superstition and force (Philadelphia 1866).

“ In casting a retrospective glance over this long history of cruelty and

” The Inquisition continued to function in Spain until 1834.

299

DEI DEHTTI

DELLE PENE.

In rebus qtubufcunque difficiUoribus non ex-
peliandunty ut quis Jimul, ^
metat ; fed praeparatione ofus eft^ ut per
gradus maiurefcant.

Bacon. Serin, iidel, n. 45.

IN MONACO

M D C C L X 1 V.

Fig. 6.

Second edition, Monaco 1764.
(Harvard Law Library)

T R A I T £

DES D E LITS

ET DES PEINES,

TRADUIT DS L’lTAUEN,

D’apres la croineme Edition revue, cor>
rigee & augmeptee par TAuteur.

Avtc des Additions del*Auteur qui
n’ont pas encore paru en Italien,

Nouvellb Edition plus correAe
que les pr6c^entet.

A PHILADELPHIE.

M, DCC ixyi

Fig. 7.

First French edition by Andre Morellet, Paris 1766.
(Harvard Law Library)

298

GEORGE SARTON

injustice, it is curious to observe that Christian communities, where the
truths of the Gospel were received with unquestioning veneration, systema¬
tized the administration of torture with a cold-blooded ferocity unknown
to the legislation of the heathen nations whence they derived it. The
careful restrictions and safeguards with which the Roman jurisprudence
sought to protect the interests of the accused, contrast strangely with the
reckless disregard of every principle of justice which sullies the criminal
procedure of Europe from the thirteenth to the nineteenth century. Frcrni
this no race or religion has been exempt. What the Calvinist suffered in
Flanders, he inflicted in Holland; what the Catholic enforced in Italy,
he endured in England; nor did either of them deem that he was forfeiting
his share in the Divine Evangel of peace on earth and goodwill to men.

“The mysteries of the human conscience and of human motives are
well-nigh inscrutable, and it may seem shocking to assert that these
centuries of unmitigated wrong are indirectly traceable to that religion of
which the second great commandment was that man should love his
neighbor as himself. Yet so it was. The first commandment, to love God
with all our heart, when perverted by superstition, gave a strange direction
to the teachings of Christ. For ages, the assumptions of an infallible Church
had led men to believe that the interpreter was superior to Scripture.
Every expounder of the holy text felt in his inmost heart that he alone,
with his fellows, worshipped God as God desired to be worshipped, and
that every ritual but his own was an insult to the Divine nature. Outside
of his own communion there was no escape from eternal perdition, and
the fervor of religious conviction thus made persecution a duty to God
and man. This led the Inquisition, as we have seen, to perfect a system
of which the iniquity was complete. Thus commended, that system became
part and parcel of secular law, and when the Reformation arose the habits
of thought which ages had consolidated were universal. The boldest
Reformers who shook off the yoke of Rome, as soon as they had attained
power, had as little scruple as Rome itself in rendering obligatory their
interpretation of divine truth, and in applying to secular as well as to
religious affairs the cruel maxims in which they had been educated.

“Yet, in the general enlightenment which caused and accompanied the
Reformation, there passed away gradually the passions which had created
the rigid institutions of the Middle Ages. Those institutions had fulfilled
their mission, and the savage tribes that had broken down the worn-out
civilization of Rome were at last becoming fitted for a higher civilization

** In the revised edition (1892) Lea wrote “ saddening ” instead of “ curious.” He was
becoming more tender, and to that extent, less objective.

A N

ESSAY

O N

CRIMES

AND

PUNISHMENTS,

Tranflated from the Italian;

W I T H A

COMMENTARY,

Attributed to Monf. Da Voltairb,
Trtnflated from the Frmh.

In rebu* quibufcumque dificUioribiu non expefion-
dum, lit quU fimul, it ferat, A metat, fed prxpan-
tiooe opus eft, ut per gradus maturefeut.

Bacon.

LONDON:

Printed for ]• Almoh, oppolite BurUnittflinJi,
PiittdiU,, MDCCLXVU.

Fig. 8.

First Enslish edition. London 1767.
(^Vidcnc^ Library)

E S S A Y

O N

CRIMES

A N Q

PUNISHMENTS,

Tranflated from the IrALiAN ;

WtTB A

COMMENTARY,

Attributed to MooC Di Voltaias.
TraoOated from tihe fAiNcm

Is 4iOoli « ci >es iiU'WiiHiili, el ,iie

* Am, M,«jimiMe<rnd^ et |n4w
■nuffriet. Bacen.

• TATK or SOOTR CAtOLlUA.

tRIMTBD AND SOLD IT DATID BRUCE, AT.
fOS SHOP IN CaVRCH-STRBBT, CHARUSTOWIL,

If OCCLZZVlt.

Fig. 9.

First American-English edition, Charlestown,
S. Carol.. 1777

CHanrard Law Library)

BECCARIA

301

than the world had yet seen, wherein the precepts of the Gospel might at
length find practical expression and realization. For the first time in the
history of man the universal love and charity which lie at the foundation
of Qiristianity are recognized as the elements on which human society
should be based. Weak and erring as we are, and still far distant from
the ideal of the Saviour, yet are we approaching it, even if our steps are
painful and hesitating. In the slow evolution of the centuries, it is only
by comparing distant periods that we can mark our progress; but progress
nevertheless exists, and future generations, perhaps, may be able to emanci¬
pate themselves wholly from the cruel and arbitrary domination of
superstition and force.”

The same conclusions were repeated in the final edition of 1892. Indeed,
Lea would have been justified in leaving them unchanged until the end of
his life (1909). And yet shortly afterwards the edifice of justice and
mercy gradually built up by our ancestors was suddenly destroyed before
our own eyes. We have been plunged back into the inquisitorial age!
The only redeeming feature of that appalling backsliding is that it was
caused by impious devils, not by ecclesiastics. The churches have learned
from bitter experience that the conversion of men by brutal or foul means
is not only criminal but futile and stupid; such means defeat their own
purpose; they fail to save anybody and the fanatics using them are cer¬
tainly doomed. Happily when dictators decreed the burning of so many
good books they probably overlooked Beccaria’s which the moral progress
of mankind had rendered obsolete. The dictators did not realize that they
themselves were giving it a new value and a new life. The perversion of
justice obtaining today in a great part of continental Europe is so pro¬
found that when the European nations are liberated they will need such a
primer as Beccaria’s little treatise in order to begin again their education
in freedom and dignity. Happily the editions of it are so numerous and
are available in so many languages, that there is not an old library which
does not contain at least one copy of it. When the time comes Beccaria
will be ready to serve humanity even as he was in 1764, and he will be
listened to with resp>ect and gratitude by our children and the children of
our children, as he was by our ancestors.

Appendix I

The persecution caused by the plague of Milano, 1630

The plague of 1630 was terrifying. It decimated the population of Milano and
demoralized the survivors.** All kinds of ugly rumors ascribing the calamity to

** Cesare Cantu: Sulla storia lombarda del secolo XVII. Ragionamenti per commento

302

GEORGE SARTON

occult agencies were circulating. According to a persistent rumor, malefactors had
smeared the walls of houses, the benches of churches, etc. with an ointment which
spread the disease. In spite of its stupidity that rumor stood out among others and
was acted upon.** A dozen people were tortured, put on the wheel, and burned to
death. There is no point in recalling the details of that tragedy which are easily
available as all the documents have been published, Processo originale degli untori
della peste del MDCXXX (464 p., 1 pi., Milano 1839). One may read also a con¬
temporary treatise by Cardinal Federico Borromeo (1564-1631): De pestUentk
(56 p., Sora 1932; Isis 19, 545). This cardinal, founder of the Ambrosiana, nephew
of Santo Carlo, believed in the reality of the crimes imputed to the anointers but
thought that the reports were exaggerated. We should not misjudge him, for that
superstition continued to flourish throughout the seventeenth century and during;
the larger part of the following one.

The first historian to attempt a critical study of the case was Pietro Verri, who
had discovered all the MS. documents ad hoc (the same which were edited in 1839),
and wrote his Osservazioni in 1777. We shall come back to that presently.

Beccaria’s little book of 1764 had a capital share in discrediting the use of torture,
partly because of its moderation and quiet common sense, partly no doubt because
it came at the right time when many people had already been consciously or uncon¬
sciously prepared to accept its argmnents. It was perhaps less influential in Italy
and Spain than in other countries because Italians and Spaniards were less prepared
than other nations to understand it. Thanks to the warm reception which the
EncyclopMistes gave to it, it was more efficient in France and England, and
strangely enough in the continental empires where the “ enlightened despotism ’’
was flourishing. The two female autocrats, Ekaterina II and Maria Theresa,
accepted its message and did their best to diffuse it. Maria Theresa patronized
Joseph V. Sonnenfels, who was teaching it in the university of Vienna, and it was
at her own request that he wrote his tract on the abolition of torture which was
very soon translated into Italian.**

In the meanwhile, administrative efforts had been made to abolish torture. A
council was held in 1772 by the archduke Ferdinand to discuss its abolition in
Lombardy. The Senate of Milano and the judicial council of Mantua formulated
strong objections. In 1776, Maria Theresa decreed its abolition without restriction
in the whole empire including of course Lombardy. More objections were made,
and the Senate of Lombardy issued a report written by one of its leading members,

at Promessi sposi (Sta ediz., Lugano 1833). Georg Sticker: Die Pest (vol. 1, 138-48,
Giessen 1908).

** That fantastic accusation was not a novdty. It had been made before, notably in
Geneva, at the time of the plague of 1542-45, and Calvin had taken an earnest part in the
extirpation of the anointers and “ semeurs de peste.” Stefan Zweig: The right to heresy.
Castellio against Calvin (71, New York 1936). George Lincoln Burr: Selections (363,
Cornell University, Ithaca 1943).

’’Joseph von Sonnenfels: Vber die Abschaffung der Tortur (Zurich 1775). The Italian
translation appeared in Milano 1776. It is included in the Bassano ed. of Beccaria (vol. 2,
215-36, 1797), Supplied apologetica A.S.M.I.R.A. del sig. di Sonnenfels, consigliere di
reggenza d’Austria e professore di politica. French transl., Memoire sur Pabolition de la
torture (Berne 1778).

BECCARIA

303

Count Gabriele Verri, concluding that the use of torture could be mitigated but not
abolished, for it was indispensable in certain cases: “ Gravitas criminis, veritas non
aliter emersura, urgentia indicia; haec tria usum torturae necessarium reddunt”
That report was deposited by Count Gabriele on April 17, 1776.

It was then that Gabriele’s son, Pietro, felt impelled to compose his Osservasioni
suUa tortura e singolarmente sugli effetti che produsse all’ occasione delle unzioni
malefiche alle quali si attribui la pestilenza che devastd Milano Fanno 1630.” Pietro
Verri treated the judicial murders of that year as a series of experiments proving
that torture defeated its own purpose. He communicated his memoir privately to
friends but did not publish it out of respect for his father, who had been the latest
apologist of judicial torture. The memoir was published only twenty-seven years
later, posthumously, in the Scrittori classici italiani di economia politica (130 p.,
Milano 1804).

In spite of the imperial decree of 1776, accused people were still tortured in the
state of Milano, and this continued until 1789 when a new imperial decree abolished
it. Its use as a method of judicial procedure ceased completely from that time on
until the beginning of the fascist era.

It is interesting to note that in this respect the despotism of the Viennese court
was more enlightened and more generous than that of the Milanese senate. Indeed,
the reform of criminal justice was strongly resisted by the patricians, senators,
magistrates, and clergy of Milano, and as usual in such cases, by a majority of the
people following like sheep their local leaders.

The documents first used by Pietro Verri for his Osservazioni were used again
by Alessandro Manzoni in his Storia della colonna infame, first published in a late
edition of I promessi sposi (Milano 1840, p. 747-864).

Appendix II

Short bibliography of Dei delitti e delle pene

A complete bibliography of Beccaria’s classic would be difficult and would take
considerable time and space. There are a great many editions published in many
languages and many countries. Even if one restricted oneself to a single language
such as the original Italian, or French, English, Spanish, one would have to con¬
sider more than one country. However, the main causes of difficulty are: (1) Many
editions were clandestine and bore no place name or a false one. E. g., Philadelphie
or Harlem may mean Paris. (2) The text of the editions varies not a little. The
arrangement of the text was modified by Morellet, and the new arrangement was
included, more or less, in the sixth Italian edition and in some of the later editions.
One should note the arrangement of each edition, the number of chapters, etc.
(3) Commentaries and letters were added in various choice and quantity to almost
every edition. Some commentaries, like Voltaire’s, were included very frequently,
others in only a few editions or in a single one. For each edition one should note
its contents and peculiarities; for each translation one should determine from which
text (Italian or foreign) it was made, and what it added to, or subtracted from,
that text. Some translations were freer than others. (4) Expressions such as “ third
Italian edition,” “ fourth London edition ” are not so definite as they seem. They
are often misleading. All the early editions and translations should be renumbered
without too much regard for the numbers printed on the title-pages.

5Bon ^en

r t r c cMn

un^

Sttttfeii

&em 3rali4nif(&en

in it

t(j^.9B<rfnffcrj (igcittii Hoc^ nic^ gebnuftm
^i*gau.{ungeu

luufi ter iieurflni^uilttgc in» A&eriirt^

unb

mit t»ie((n ^imcrhin^enMxrme^rt.

ut
2

lUm,

ttritflM 9(6r((t)t ^artl^blonitii.

» 7 6 7*

F«J. 10.

First German edition, Ulm 1767.

CHas-v»r<l I.^w K^it>rakS^>

VERHANDELING

OVER OE

MISDAADEN

STRAFFEN.

Nttr de dade verbeterde en vennectdeide
Italiaanichc Ui^ve.

Wur by, de

VERKLA ARING

Op dit werkje

Van den Heere de VOLTAIRE.

VU htt Fram wlmM.

Te A M S T E L D A M,.
By GERRIT BOM i7<».

Fig. 11.

First Dutch edition. Amsterdam 1768.
Cl^arvard J~mw I.ibrmrx>

BECCARIA

305

There exists a complete MS. in Beccaria’s hand, with annotations written by
Pietro Verri. The differences between that MS. and the princeps are numerous
and considerable (Bouvy, p. 96, 1889). Cesare Cantu attempted a critical edition
which was appended to his book on Beccaria (1862, p. 379-462), but his effort is
insufficient. A critical edition giving' the variants of the text and of the Risposta
and main commentaries is badly needed.

The following notes concern only the main editions and translations; they are
meant to introduce the subject and illu.strate its complexity. The Harvard Library
(Widener Library) and the Harvard Law Library own between them a large
collection of editions in many languages. I have examined many, but not all, and
express my gratitude to the Librarians for enabling me to study these volumes,
many of which are of great rarity, and to photogfraph a few of them. The marchese
Giulio Beccaria (G. B.) had made a collection of editions and translations and
published a list of them in the Opere (vol. 1, p. Ixxi-lxxix, Milano 1821). That
list is incomplete and not free from errors.

I. Italian editions (1764)—(1) The princeps was printed in Livorno 1764 with¬
out name of author, place or printer. It was printed by the Coltellini press directed
by Aubert; the proofs were read by Pietro Verri. It is a small quarto 23 x 16 cm.,
105 p. The text is not divided into chapters, but the titles of the (future) chapters
are printed in the margins. We reproduce the title-page and the last page (figs.
4, 5). Copy in Harvard Law School.

(2) Second edition, Monaco 1764. IS x 10 cm., 112 p. Divided into chapters
(fig. 6). Copy in Harvard Law School.

The so-called “ sixth ed.”, Harlem (— Paris) 1766, includes the Risposta
(p. 219-314).

A very convenient ed. of Beccaria’s text and many other treatises was printed
by Remondini in Bassano (4 vols. 1789, again 1797). I have not seen the ed. of
1789 but have used that of 1797 very often. It is a precious collection of related
contemporary texts.

G. B. lists 28 Italian editions from 1764 to 1810. The Opere of Beccaria were
first published in 2 vols. Milano 1821-2, again in 1824, 1831; Firenze 1854 with
preface by Pasquale Villari.

It should be noted that Italian editions appeared not only in Italy, but also in
Lausanne, Paris, Vienna, London. According to G. B. three London editions were
printed in Venezia (1774), Pavia (1794), Piacenza (1801).

II. French editions (1766)—The first edition of the translation by Andre
Morellet was published in Philadelphie (—Paris), 1766. The copy which I
examined in the Har'vard Law Library (16 x 9.5 cm., xxxxi -j- 239 p.) is not neces¬
sarily a copy of the very first edition (fig. 7). The book was so successful that it
was reprinted within the same year. G. B. lists three more editions of 1766, two
in Lausanne, one in Amsterdam. One of the Lausanne ed. of 1766 (16.5 x 9.5 tm.,
xxxii -|- 286 p.) claims to contain additions by the author not yet published in
Italian. G. B. lists 14 French editions, 1766 to 1821.

The best of the early French editions is supposed to be the one by comte Pierre
Louis Roederer (Metz 1754-1835) printed by the Imprimerie du Journal dJicononUe
politique, a periodical issued every decade, created by him in 1796 (NBG 42, 492-
95, 1863). It appeared in Paris 1797 and includes many commentaries and related

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306

GEORGE SARTON

texts. I have used chiefly the edition prepared by J. A. S. Collin de Plancy (Paris
1823), including many documents, notes, and portrait.

III. European English editions (1767)—The first English edition is probably
the one printed in London 1767 (fig. 8). The copy in Widener Library is a vol.
21 X 13 cm., xii -j- 180 -}- Ixxx p. The last group of pages (Ixxx p.) contains
Voltaire’s commentary. The Harvard Law Library has also an edition printed in
Dublin 1767, a vol. 20x 12 cm., xiv -j- 134 -j- lx p., which contains the same text,
with the same preface, and Voltaire’s commentary printed similarly in appendix
(lx p.). The translator is not named, and the preface unsigned.

Other editions appeared in London 1769, 1770, 1775, 1785, 1801; Glasgow 1770;
Eldinburgh 1778, 1788, etc.

IV. German editions (1767)—The first German translation was printed in Ulm

1767. Copy in Harvard Law Library (fig. 10). A vol. 18x 11 cm., 198 p. Zus’dtu
su der dritten Auflage p. 199-214 (that sheet may have been added to remaining
copies of the first edition?). Translation made from the third Italian edition.

Other German editions, Breslau 1778 (two), Leipzig 1798, etc.

V. Dutch edition (1768)—The first Dutch translation was published in Amsterdam

1768. Copy in Harvard Law Library (fig. 11). A vol. 21.5 x 12.5 cm., 20 -|- 196p.
Translation made from the third Italian edition, with Voltaire’s commentary.

VI. Spanish editions (1774)—First Spanish translation, Madrid 1774 (not seen).
Two vols. containing Beccaria’s treatise and various other texts. Other Spanish
translations, Philadelphia 1823; by Juan Antonio de las Casas, Paris (n. d., in
Biblioteca universal), Paris, 2nd ed. (1828). Madrid 1820. Madrid 1879, this
translation by Pascual Vincent was derived from the Italian text of Cesare Cantu,
1862.

VII. American English editions (1777)—The first is the one printed in Charles¬
town, South Carolina, 1777. Copy in Harvard Law Library (fig. 9). A vol.
19 X 12 cm., xii 155 p. It includes Voltaire’s commentary. Other early editions,
Philadelphia 1778, 1793.

VIII. Greek edition (1802)—The Greek translation was made from the Italian
text, as modified by Morellet, and was published in Paris 1802. Copy in Widener
Library (fig. 12). A vol. 20x12.5 cm., 32-f-284p. It was made by no less a
person than ‘ASofidvruK Koparp of Chios, who called himself in French Diamant
Coray (born in Smyrna 1748, died in Paris 1833), the outstanding Greek writer
of a century ago, educator, moralist, physician, one of the founders of modem
Greece. Coray dedicated his translation to the newly constituted Septinsular
Republic (republic of seven Ionian isles). See NBG (vol. XI, 765-69, 1855), or
any Greek encyclopaedia.

IX. Russian editions (1803)—The first Russian translation was made from the
French text of Morellet by order of the emperor Alexander I and printed by the
oflicial press (St. Petersburg 1803). It was made by Dimitri Ivanovich Yazykov
(1773-1845), who was connected with the imperial department of public education
from 1802 to 1833 and became its director; he was permanent secretary of the
Russian Academy, translator of Montesquieu. His translation of Beccaria includes
Diderot’s observations and the Morellet-Beccaria correspondence. Title-page from
copy in New York Public Library (fig. 13). The title of Dostoyevski’s famous

308

GEORGE SARTON

novel, Crime and Punishment (1866), was most probably inspired by that trans¬
lation, the selfsame words being used.

A new translation was made by Ivan Sobolev, otherwise unknown to me (Radom,
Poland, 1878). Copy in Harvard Law Library.

X. Hungarian edition (1887)—Translation by Tamai Janos (Budapest 1887).
Copy in Harvard Law Library.

XL Czech edition (1893)—Translation by Josef S14de6ek (Prague 1893). Copy
in Harvard Law Library.

All the illustrations were obtained from the Harvard Libraries, except figs. 3
and 13 for which we are indebted respectively to the New England Deposit Library
in Boston and to the New York Public Library.

Appendix III

Short bibliography on Beccaria

My information was derived mostly from Beccaria’s own writings and from the
commentaries and documents appended to various editions. Specific references are
provided when necessary in my article. One may consult also:

Cesare Cantu: Beccaria e il diritto penale (Firenze 1862). French translation
(Paris 1885).

Carlo Casati: Lettere e scritti inediti di Pietro e Alessandro Verri (4 vds.,
Milano 1879-81).

Eugene Bouvy: Le comte Pietro Verri, ses idies et son temps (Paris 1889).
Angelo Ottolini: Pietro Verri e i suoi tempi. Con la ristampa dei suo scritti
inediti (Palermo 1921).

Nino Valeri: Pietro Verri (Milano 1937).

Carlo Antonio Vianello: La vita e Vopera di Cesare Beccaria. Con scritti e docu-
menti inediti (Milano 1938).

Oreste Ciattino: Cisar Beccaria (Buenos Aires 1938).

Marcello T. Maestro: Voltaire and Beccaria as reformers of criminal law (190 p.,
Columbia University Press, New York 1942). Seen only after the writing
of my own paper and not used.

FREDERIC BERARD
HISTORIEN DE LA MEDECINE

RAYMOND DE SAUSSURE

Nous n’avons que peu de renseignements sur Berard et il serait a sou-
haiter qu’apres la guerre quelqu'un ecrivit sur la vie et les oeuvres de ce
m^ecin une etude plus complete. Ce brillant esprit naquit a Montpellier
le 8 novembre 1789, I’annee meme de la revolution. II fit ses etudes dans
sa ville natale ou il se distingua rapidement par la clarte de son intelligence
et le zele qu’il mettait a ses etudes.

Comme Bichat, comme Georget, comme tant de romantiques, il eut un
talent precoce et une intense vie intellectuelle. On eut dit qu’un sombre
pressentiment les prevenait que leurs jours etaient comptes. Berard
mourut a 39 ans, le 16 avril 1828.

Peu de temps apres avoir soutenu une these sur la Medecine Naturelle
(1811) il commenca a donner des cours. Il n’avait pas 25 ans, mais il
etait fort apprecie de ses eleves. Il les quitta pour se rendre a Paris ou il
contribua au Dictionnaire des Sciences Medicales. Dans chaque article
qu’il redigea, nous retrouvons le souci d’un expose historique et philo-
sophique de la question. Cette activite le mit en relation avec beaucoup de
savants de son epoque et sa correspondance serait interessante a retrouver.

En 1816, il revint a Montpellier ou il fut nomme professeur d’Hygiene
quelques ann^s plus tard.

En plus de sa these et de I’ouvrage que nous analyserons tout a I’heure,
Berard a ^rit les livres suivants:

1“. Essai sur les anomalies de la Variole.

(En collaboration avec Lavit, Montpellier 1818)

2“. Doctrine des Rapports du Physique et du Moral de I’homme Paris
1823.

(Cet ouvrage qui cherche a refuter I’ecole materialiste de Condillac
et de Cabanis contient beaucoup d’aperqus historiques sur diverses
questions psychologiques et philosophiques).

3". Lettres inedites de Cabanis a F. sur les causes premieres.

(avec notes) Paris 1824 in 8“.

4*. Sur I’amelioration progressive de la Sante Publique par I’influence
de la civilisation. Montpellier 1826. in 8°.

Dans la Doctrine des Rapports du Physique et du Moral, Gabon & Cie,

309

310

RAYMOND DE SAUSSURE

Libraires de Berard annocent de cet auteur un autre ouvrage, soi disant
sous presse et qui porte le titre suivant: “ Determination experimentale
des rapports du systeme nerveux en general et de ses parties, avec la vie
animale et organique, dans les animaux de toutes les classes, depuis les
insectes jusqu’aux mammiferes.”

Nous n’avons pu trouver aucun exemplaire et aucune citation de cet
ouvrage, en sorte que nous ne savons pas s’il a paru ou non.

Malgre sa grande erudition et ses qualites d’exposition, Berard, comme
tant d’hommes qui sont restes dans la province franqaise, est tombe dans
Toubli. II merite d’en ressortir.

Age de 30 ans, Berard entreprend un expose des doctrines de TEcole
de Montpellier. Cet expose avait surtout pour but de clarifier ses propres
idws, mais il se proposait aussi de defendre cette antique faculte que Ton
songeait a supprimer depuis la Revolution Francaise.

L’ouvrage intitule: “ Doctrine Medicale de I’Ecole de Montpellier et
Comparaison de ses Principes avec ceux des autres Ecoles d’Europe”
(Montpellier et Paris 1819) est divise en deux parties. La premiere est
consacree a Tetude des travaux qui se sont succedes de Sauvages a Lordat;
la seconde est un expose des doctrines m^icales de I’antiquite dans laquelle
I’auteur fait quelques rapprochements avec la pens^ medicale de Mont¬
pellier. Nous laisserons de cote cette seconde partie, moins originale et
nous jugerons I’historien sur la premiere partie de son livre.

On pourrait reprocher a Berard d’avoir writ une histoire des principes
plus qu’une histoire des doctrines, mais ceci admis, nous restons pleins
d’admiration pour la maturite de jugement dont il fait preuve. Deja ce
choix de porter son interet sur revolution des methodes plutot que sur
celle des idws t^oigne d’un sens des valeurs exceptionnel a cet ^e.
” La Science des methodes est la premiere de toutes les sciences ” affirme
t-il en ouvrant son livre. “ La methode est le ressort de toutes les opera¬
tions intellectuelles et morales (p. 12); les grandes revolutions de la
medecine sont venues de la philosophie, c’est pourquoi nos professeurs
rappelent souvent les principes de Tart de raisonner et c’est a eux quils
ramenent toujours les questions les plus particulieres parcequ’ils pensent
que la philosophie generale renferme, a proprement parler, le code de toutes
les dwisions de detail.” (p. 15)

Berard rappelle que si ailleurs on conteste les droits de la science et on
ne veut que se hater de jouir des resultats de Tart, fwole de Montpellier
a toujours insiste sur la nwessite d’etablir avant tout de solides principes.
Qu’on se souvienne de ce passage de Barthez: ” En afiFectant de dwigner
par le nom vague de metaphysique des thwries abstraites qui appartiennent

FREDERIC BiRARD: HISTORIEN DE LA M^DECINE

311

essentiellement a la medecine pratique, on veut faire entendre qu’elles sont
vicieuses ou etrangeres aux objets qu’elles doivent avoir. Mais c’est ce
ou’il faudrait etablir avant tout . . . Dans toutes les parties des sciences
naturelles, les vues generales et abstraites qu’on tire des faits, suivant les
regies d'une bonne logique, peuvent seules Her les experiences et les observa¬
tions de fa^on a en faire sortir de nouveaux principes qui seraient simples
et vastes.” (Barthez: Traite des Maladies Goutteuses, Introduction p.
bcxxiii)

Nous ne suivrons pas en detail I’expose de Berard. De la Renaissance
a la Revolution il distingue trois periodes: celle de I’erudition, celle des
hypotheses ou des causes supposees, et celle de I’induction ou de la
recherche des causes experimentales.

II cherchera a prouver que depuis Boissier de Sauvages, I’Ecole de
Montpellier s’est efforcee de faire triompher I’experience et I’observation.
II cite des textes ou les principes d’une saine science sont exposes avec
toute la nettete voulue, mais il reconnait que la {^upart des auteurs jusqu’a
Dumas sont tombes dans les erreurs meme qu’ils denonqaient.

C’est dans cet expose critique que ressortent les qualites maitresses de
ce jeune savant. Ecoutez avec quelle sagesse il Hxe les principes de sa
propre science. “ Lorsqu’on veut juger d’une doctrine et apprecier I’influ-
ence qu’elle a eue sur les progres d’une science, il faut lire successivement
ct dans I’ordre de leur publication les ouvrages qui ont prec^e et suivi
I’introduction de cette doctrine. Des lors on voit naitre celle-ci et Ton
peut mesurer sans exageration les pas qu’elle a fait faire a la science.
A s’en tenir a des idees a priori ou a des considerations generales, c’est
le moyen de n’avoir aucune notion claire et exacte. C’est pour avoir omis
ce pr^pte que tous les jours on attribue a une doctrine ce qui ne lui
appartient nullement.” (p. 60 )

Cest pour se conformer a ce principe que Berard etudie successivement
les oeuvres de Boissier de Sauvages, Lacaze, Bordeu, Robert, Fouquet,
Deseze, Barthez, Grimaud, Dumas et Lordat. Il montre qu’a travers eux,
la mWecine s’est affranchie de sa d^ndance trop etroite de la physique
et de la chimie, que I’observation est devenue plus attentive pour dwrire
les phenomenes de I’etat de sante et de I’etat de maladie et qu’ils sont
arrives a d^ouvrir quelques propri^es fondamentales des etres vivants.

S’appuyant en partie sur ces maitres, en partie sur son propre jugement,
Berard formule avec clarte les principes suivants: “ Dans toute science
naturelle, ^rit-il en commentant la pens^ de Barthez, les hypotheses qui
ne sont pas d^uites des faits propres a cette science, mais des petits
faits empruntes a une science plus ou moins ^rangere, sont contraires a

312

RAYMOND DE SAUSSURE

la bonne methode de i^iIoso(^er. II serait absurde, pour voir un objet,
d’en regarder un autre dont on n’aurait pas prouve I’identite avec le pre¬
mier, ce qui serait aller a Londres pour savoir ce qui se passe a Paris.
C’est cependant ce qu’on a presque toujours fait dans la science medicale;
au lieu d’etudier les etres vivants dans les phenomenes qui leur sont pro-
pres, on les a consideres dans les corps prives de vie. Encore un coup,
c’est tourner le dos a un objet pour le mieux voir. On croyait, il est vrai,
(|u’il y avait analt^ie entre les uns et les autres, mais c’etait cela meme
qu’il fallait prealablement etablir et dans ces vues, il fallait ccwnmencer par
etudier les phenomenes vitaux en eux memes.”

Le don d’exposition de Berard est remarquable. Il est vivant tout en
ctant precis et clair; il a un style agreable sans etre prolixe; il va a
I’essentiel dont il degage le contour avec Tart d’un sculpteur.

Void un autre principe que Berard enonce avec la meme clarte. “ Dans
la recherche des lois secondaires d’une cause ou faculte experimentale, Ton
doit employer le nom de cette faculte preferablement a tout autre. Ainsi,
par exemple, je dois me servir du mot sensibilite, lorsque j’dudie les lois
de cette propride quoique cependant je ne sache pas ce que c’est la sensi¬
bilite. Cette denomination a pour moi un sens vague et indetermine, elle
ne specifie rien sur la nature de cette force, je dois I’employer pour m’em-
pdher de me jeter dans quelque hypothese que ce soit ... Si on y ajoute
une autre idd, quelle qu’elle soit et quelle que probable qu’elle paraisse,
ce ne pent etre qu’une hypothese qui sera la source fdonde de mille
erreurs.” (p. 85)

La contre partie de ce principe, Berard I’expose un peu plus loin avec
sa vivacite coutumiere: “ Ainsi, je suppose que Ton ddide avec Bichat et
tant d’autres que la vie depende de I’organisation et des proprietes locales
des tissus; avec Cullen de Taction nerveuse, avec Stahl de Tame, etc., il est
tres sur que des cet instant Tesprit sera fixe dans une hypothese gratuite
et, que ce sera a travers ce prisme trompeur qu’il examinera tous les faits.
11 est incontestable que Ton ne tiendra compte que de ceux qui seront en
rapport avec Thypothese que Ton aura choisie et que Ton ecartera les uns
et torturera les autres. On sera loin de les considerer en eux-memes et de
les reunir en lois experimentales, mais on ne s’occupera que de les rattacher
tant bien que mal a cette meme hypothese, C’est a dire a rendre plus
probable une proposition qui par sa nature est souvent arbitraire et sup¬
pose. En un mot il serait aise de montrer qu’en partant de pareils principes
on travaillerait la science pendant des siecles entiers presqu’en pure perte,
ou du moins sans autre profit que celui des faits nouveaux auxquels
Thypothese aurait pu conduire.” (p. 93)

FREDERIC b^:rard: historien de la m6decine 313

Berard avait compris que chaque science doit avoir ses methodes et
doit etre etudiee pour elle meme. “ Les sciences ne sont pas soumises les
unes aux autres, ecrit-il, chacune d’elle doit reposer sur les faits qui lui
sont propres, puisqu’une science n’est, comme nous I’avons deja dit plu-
sieurs fois, que la collection systematique des faits qui lui appartiennent.
Cette loi conservatrice de leurs droits respectifs, a ete violee dans tous
les temps; et c’est a cette circonstance qu’il faut rapporter la plus grande
partie des erreurs qui ont arretes leurs progres.

Les sciences physiques doivent avoir pour base des faits du meme ordre.
Tant qu’on les a etudies dans la theologie mystique, dans I’ontologie et
dans la metaphysique, elles n’ont pas meme existe.” (p. 209)

“ Les sciences medicales reposent sur les faits particuliers que presente
rhomme vivant dans I’etat de sante et I’etat de maladie et on les a toujours
associes avec la theologie (le mysticisme), la physique, la mecanique, la
chimie, les mathematiques, la metaphysique, I’ideologie, Tontologie scol-
astique ou la science des abstractions personnifiees, la grammaire ou les
vraies distinctions des mots, etc, etc.”

“Ainsi par rapport a la medecine, la physiologic repose sur des faits
physiologiques, comme la doctrine pathologique sur des faits de ce dernier
ordre. Ce qui arrete les progres de celle-ci, c’est que Ton ne I’a pas con-
sideree en elle-meme, et comme une science propre; on ne I’a prise que
pour une des divisions de I’application de la physiologic; et cette associa¬
tion trop etroite et prematuree a detruit, j’ose le dire, la pathologic. On a
commis la meme erreur par rapport a la therapeutique, a I’hygiene et aux
autres sections de cette science. Avant de les constituer par elles memes.
par leurs faits et leurs principes, on les a etudiees a I’aide d’idees physio¬
logiques, que Ton n’aurait pasi du mettre en premiere ligne, lors meme
qu’elles auraient ete aussi vraies et aussi certaines qu’elles etaient le plus
souvent hypothetiques et fausses.” (p. 210-211)

On trouve dans les livres de Berard une foule de remarques concernant
I’histoire des sciences qui montre avec quelle attention et quelle reflexion
il savait lire.

“ Plus on reflechit a I’histoire des sciences, ecrit-il encore, plus on voit
que les grands maitres avaient ete toujours assez fideles a I’observation.
Mais ils avaient laisse echappe une conjecture, ils s’etaient permis un mot
equivoque; le germe d’erreur a fermente et le systeme entier est tombe en
pourriture. Quiconque veut etablir une doctrine d’une certaine duree doit
surtout prendre ses precautions contre I’avenir; c’est I’enemi qu’on redoute
le moins et celui cependant qui est le plus a craindre. L’on doit se premunir
moins contre les attaques des adversaires que contre les exagerations des
amis. (p. 109)

314

RAYMOND DE SAUSSURE

Pour essayer de mieux suivre ce principe, Berard s’est astreint a une
discipline severe; il ecrit dans sa Doctrine des Rapports du Physique et
du Moral: “ Une habitude qui m’a toujours paru propre a conserver i
I’esprit toute son independance et a le preserver de ses idees fixes qui sont
dans les sciences une sorte d’alienation, source de toutes les hypotheses et
de tous les systemes, c’est de faire marcher presque de front I’etude de
deux sciences, de deux doctrines diametralement opposees. (op. cit. p. 643)

Berard a une grande connaissance des textes et lorsqu’il veut faire
ressortir la pensee d’un auteur, il sait en extraire les pages les plus carac-
teristiques. Nous ne pouvons en donner de nombreux exemples id,
contentons-nous de citer I’attaque de Deseze contre les mecaniciens:

“ Le principe des mecaniciens est-il vrai ? Le corps humain est-il une
machine stato-hydraulique ? Y a-t-il une mobilite spontanee ? Le premier
mobile n’est il pas etranger aux rouages qu’il faut mouvoir ? Est-on bien
sur d’ailleurs qu’il y ait une physique dont les lois puissent embrasser tous
les corps naturels ? La vraie philosophic doit-elle toujours generaliser les
causes et restreindre la nature aux seules manieres d’agir analogues a nos
conceptions? Pourquoi n’accorderions nous pas aux corps inanimes une
physique particuliere ? Les facultes qu’on remarque en eux et qu’on ne
remarque qu’en eux, n’annoncent-elles pas qu’il faut une classe a part qui
a ses lois d’action, ses lois de mouvements independantes de celles qui
dirigent les autres corps. La sensibilite qui est leur premier ressort a-t-elle
le moindre rapport avec les forces motrices connues ? Quoi! Une machine
active et sensible dans toutes ses parties, pourra etre comparee a une
machine inactive, insensible, morte, dont une force etrangere meut tous
les ressorts. Jetez les yeux sur la marche des maladies, sur le travail de la
coction, sur les mouvements tumultueux des crises, sur les sympathies de
tous les organes, sur les depots critiques, sur les metastases, sont-ce-la des
phenomenes concordants avec les lois physiques admises dans I’^onomie
animale et n’aimoncent-elles pas un agent conservateur, qui modifie a son
gre tous les agents vitaux pour le plus grand avantage de I’etre qui recoil
de lui le sentiment de vie? (Deseze, Recherches p. 16)

Les qualites maitresses de Berard sont celles de la critique; on reste
frappe d’admiration par la surete de jugement de ce garqon de 30 ans qui
non seulement discerne le vrai du faux dans les theories de ceux qui I’ont
devance d’un demi siecle, mais qui garde cette meme justesse de vues
lorsqu’il s’agit de ses propres maitres dont il vient a peine de quitter
I’enseignement. Pour que Ton puisse s’en convaincre, nous reproduisons
ici quelques pages critiques sur Barthez et ses successeurs:

“ Nous avons demontre, ecrit-il, que Barthez n’avait jamais fait usage

FREDERIC b^:rard: historien de la medecine

315

du principe vital comme un moyen unique et absolu d’explication, ainsi
qu’on le lui a reproche; mais nous sommes obliges de convenir que la
notion theorique que ce mot represente a pu entrer dans les combinaisons
de sa pensee, alterer plus d’une fois la purete des resultats de I’experience,
et que. comme il le dit lui meme ce mot a pu lui servir pour lui faciliter
la conception des phenomenes, ce que precisement il devait eviter d’apres
ses principes.” (p. 105-106)

' Plus loin, a partir de la page 110 Berard devient plus precis encore:
“ Le mot de principe vital repand dans le language physiologique une tres
grande obscurite; il detourne I’attention de I’observation des phenomenes
et de leur comparaison analytique, ce qui constitue, selon nous, toute la
science, pour la diriger vers la recherche des causes ou vers leur pretendue
decouverte, ce qui doit la detruire tot ou tard. Si les ouvrages de Barthez
sont si peu lus, si peu compris, si mal entendus, c’est a lui meme qu’on
doit s’en prendre. Ce mot metaphysique, qui revient a chaque ligne et que
I’auteur repete avec une dangereuse complaisance, distrait le lecteur et use
toutes les forces de son intelligence dans des abstractions trop relevees et
souvent perdues dans le vagpie des hypotheses. Si Ton donnait une nouvelle
^ition des Elements de la Science de THomme, en retranchant complete-
ment I’expression de principe vital et en lui substituant celle de force vitale,
en se servant meme de celle-ci aussi peu que possible, et en se contentant
d’exprimer tout simplement les diflferentes classes de phenomenes et leurs
lois experimentales; la doctrine de Barthez deviendrait par cela seul et
sans autre changement aussi claire dans I’exposition qu’elle est inebranlable
dans les dogmes. Elle le serait meme beaucoup plus que toutes celles ou
Ton s’ efforce en vain de faire concevoir les phenomemes vitaux par des
analogies physiques, mecaniques, chimiques ou organiques, auxquelles on
n’entend rien au fond, pour peu qu’on ait I’esprit juste et qu’on ne se paye
pas de mots ou d’idees superficielles. Elle n’aurait des lors plus besoin
que de developp>ement dans les details, chose que Barthez a un peu trop
negligee; mais Barthez n’etait pas un maqon, c’etait un architecte; c’etait
Michel Ange concevant le plan de I’eglise de Saint Pierre, et laissant a
des mains moins habiles le soin de I’execution.”

“Une observation importante a faire encore par rapport a la maniere
de Barthez, c’est qu’il procede presque toujours par la methode syn-
thetique. C’est ainsi qu’il arrive de plein vol, et des son entree dans la
carriere de la science, a I’expression ou a la formule la plus generale de
tous les mouvements du corps vivant (principe vital) ; en descendant
ensuite de cette expression ou de ce fait primitif aux faits secondaires,
il decouvre, dans ces derniers, des analogies moins etendues, il en forme

316

RAYMOND DE SAUSSURE

des combinaisons nouvelles, les etudie sous le plus grand nombre de leurs
rapports, et s’essaie ainsi a determiner la valeur de I’inconnue, exprimee
dans I’enonciation du probleme.

“ Cette methode suppose et annonce sans doute un grand genie, mais
elle me parait dangereuse. C’est la voie la plus courte, mais la moins sure.
II se pourrait que Ton se fut trompe dans la premiere vue, surtout en
regardant si vite; des lors tons les travaux successifs seraient alteres par
une premiere erreur. C’est prendre une lunette, au lieu de se servir de ses
yeux; on pent y voir plus loin, mais le verre pent preter aux objets des
couleurs mensongeres. D’ailleurs, on borne les progres que Ton peut faire
dans une science. Enfin, cette methode est necessairement obscure, puis-
qu’elle semble souvent supposer prealablement la connaissance de ce qu’elle
veut enseigner.

“Au contraire, la methode analytique, c’est a dire, celle qui dans la
physiologie s’deve des faits particuliers aux phenomenes generaux; de
ceux ci-aux forces qui les produisent; de celles-ci a la notion de leur
reunion en une force unique; cette methode dis-je est sure et facile; elle
permet un libre examen des dogmes, et laisse une place commode a tous
les perfectionnements possibles.” (p. 110-112)

La prudence scientifique de Berard ressort encore dans le passage
suivant: “ Pour mon compte, je I’avoue franchement, les mots de principe
vital, de principe d’harmonie ou de tout autre analogue, me paraissent
trop difficiles a manier pour que j’ose m’en servir; je ne me sens point
assez de force d’esprit pour m’exposer a la vaine gloire de braver le danger
que Barthez lui-meme n’a pas toujours surmonte malgre ses intentions
formelles et ses protestations si souvent renouvelees. D’ailleurs, je ne vois
point la n^essite d’admettre des mots de ce genre. L’unite vitale est un
fait, elle est I’expression de mille faits; elle constitue le dogme fondamental
dans la science des etres vivants. Les preuves que Barthez en a presentws,
et les beaux developpements que leur a donne Monsieur Lordat, mettent
cette question hors de doute; mais je n’ai besoin que de transmuer ce fait
en loi. Je ne vois pas d’obligation de rechercher la cause de cette unite,
et encore moins de I’indiquer par un mot qui ferait entendre que je I’ai
trouv^ dans des analogies avouees ou secretes prises de I’unite de principe
moral et de son action.” (p. 185-186)

Bien qu’il I’ait defendue avec une eloquence remarquable, on pourrait
attaquer la these fondamentale de Berard. Cet habile avocat de I’Ecole de
Montpellier plaide en effet que I’essentiel de la doctrine de son Universite
ne reside pas dans les theses vitalistes, mais dans I’elaboration sans cesse
perfectionn^ d’une doctrine de I’observation d’ou toute hypothese hazar-

FREDERIC b^:rard: historien de la m^decine 317

deuse serait exclue. Certes les textes qu’il avance sent convainquants, mais
ce ne sont pas eux que Ton avail blames en reprochant a la Faculte de
Rabelais d’etre devenue une faculte de philosophie. Berard s’en tire par
une habile pirouette mais comment lui en voudrions nous d’avoir deploye
tant de talent pour defendre son Alma Mater?

Cette intention est la plus clairement exprimee dans le passage suivant:
"L’on pent se convaincre que Monsieur Dumas suivait en general la
maniere de philosopher de Barthez; il sentit cependant vivement le danger
des abstractions realisees et reconnut que son illustre maitre n’avait pas
toujours echappe a ce danger. M. Dumas me parait done faire une epoque
tres importante dans I’histoire de la philosophie de notre ecole; il s’efforqa
le premier de la debarasser de quelques abstractions metaphysiques qui
n’en faisaient pas sans doute le fond et I’essence comme Ton nous le
reproche si souvent, mais qui enveloppaient et defiguraient sa veritable
doctrine.

Il a mis les travaux de ce corps illustre en harmonie avec les travaux
de la philosophie et Ton pent calculer deja les grandes transformations
qui seront necessairement le resultat d’une direction plus sage et plus
modeste.” (p. 159)

Malgre tout le sens critique, dont Berard fait preuve a propos d’autrui,
il est tombe grossierement dans les erreurs qu’il avail signal^s. Nous
pourrions citer maints passages de sa Doctrine des Rapports du Physique
et du Moral ou il n’a pas su etre fidele a ses principes. Ses writs con-
tiennent neanmoins des pages lumineuses qui meritent d’etre lues encore
aujourd’hui.

LE MANUSCRIT DU REGIME DU CORPS D’ALDEBRANDINO.
DE LA BIBLIOTHEQUE D’AJUDA, A LISBONNE

AUGUSTO DA SILVA CARVALHO

Un des effets du retablissement de la tradition hippocratique et galenique,
du aux Arabes, dans la medecine du XIII' si^le, fut I’abandon des super¬
stitions qui consideraient les maladies et surtout les epidemies, comme des
chatiments imposes aux peuples par leurs peches, en etablissant la doctrine
qui reconnaissait dans les alterations de la sante, les consequences uniques
de la lutte de Torganisme avec le milieu ou il vit.

Le corollaire, qui devait naturellement s’en suivre, fut la necessite
indudable d’armer I’individu pour cette lutte par les moyens appris par
I’observation et I’experience. Surgirent done de toutes parts des ecrits sur
I’hygiene.

Un des plus notables traites de ce genre fut le Regime du Corps de
Maitre Aldebrandino de Florence ou plutot de Sienne, puisqu’il naquit
dans cette ville vers 1216.^ Ce manuscrit considere precieux par les
philologues est non moins apprecie par les historiens de la medecine,
puisqu’il est le premier ecrit medical du Moyen Age, qui ne fut pas writ
en langue latine.

Ce traite d’Hygiene et de Dietetique, dans sa quatrieme partie intitulM
Phisanomie, fait connaitre les moyens d’evaluer les aptitudes morales des
individus d’apres leurs caracteres physiques.

L’opinion la plus suivie sur I’origine de ce manuscrit, est que Maitre
Aldebrandino, ayant quitte sa patrie pour la cour de Florence, ou il fut
attache a la personne de la Comtesse Beatriz, I’^rivit pour elle et le lui a
dedicace, vraisemblablement en 1256.

Cette princesse etait fille de Thomas, comte de Savoie. Elle fut mariw
en 1220 au comte de Provence, Raymond Berenger IV et donna le jour
a quatre filles, la femme de Saint Louis, la Reine d’Angleterre, la femme
de Richard empereur d’Allemagne et la souveraine de la Provence.

Roger Pepin * dit:

Littre ne connaissait que trois manuscrits du Rigime du Corps, M. P. Meyer en
citait onze et, en dernier lieu, M. Thomas en signalait dix-sept. Si nous avons eu
I’heureuse fortune de pouvoir ajouter a cette derniere liste dix-huit autres manu-

* Le Regime du Corps de Maitre Aldebrandin de Sienne, publie par les docteurs Louis
Landouzy et Roger Pepin, avec une preface d’Antoine Thomas, Paris, 1911;—A. Thomas,
L’identite du medecin Aldebrandino de Sienne, Romania, 1906.

• Loc. cit., p. xxi.

.318

LE MANUSCRIT DU REGIME DU CORPS d’aLDEBRANDINO 319

scrits, ce qui en porte le chiffre a trente-cinq, nous ne pretendons pas les avoir tous
rassemblis, pensant, au contraire, qu’il en existe encore un certain nombre qui ont
pu echapper aux recherches, de par les titres trompeurs qui leur ont ete attribues,
et sous lesquels ils peuvent bgurer dans les catalogues.

Void le denombrement des manuscrits connus, fait par Rt^er Pepin:

Paris, Bibl. Nat; fonds franqais: 2021 (XIII* s.); 14822 (XIII* s.); 1444
(XIII* s.); nouv. acq. fr. 1104 (XIII* s.); 25247 (XIII* s.); 2001
(XIV* s.); 1109 (XIV* s.); 12323 (XIV* s.); nouv. acq. fr. 6539
(XIV* s.); 2039 (XIV* s.) ; 1288 (XV* s.); 2022 (XV* s.).
Arsenal, 2510 (XIII*s.) ; 2511 (XIV* s.) ; 2814 (XIV*s.); 2059 (XIV* s.) ;
2872 (XIV* s.) ; 3190 (XV* s.).

Niort, 70 (XIV* s.).

Londres, Musee Britannique; Sloane 2435 (XIII* s.); 3525 (XIV* s.); 2806
(XIV* s.); 2986 (XIV* s.); 3152 (XV* s.); 2401 (XV* s.).
Oxford, Bodley 179 (XV* s.).

Ashburnham, Barrois 265 (XIV* s.).

Bruxelles, Bibl. Royale, 11130-32 (XIV* s.).

Rome, Vatican; fonds de la reine Christine 1451 (XIV* s.; fragment); 1256
(XV* s.); 1334 (XV* s.).

Venise, Marciana; Gall. App. X (XV* s.).

Florence, Laurenziana; Ashburnham 1076 (1006) (XIV* s.).

Turin, M. IV, 11 (XV* s.).

Lisbonne, Bibl. Royale d’Ajuda, ms. non catalogue (XV* s.).

Roger Pepin n’avait pas de renseignements sur Texemplaire de Lisbonne.
Au VI* Congres International d’Histoire de la Medecine reuni a Leyde
et Amsterdam en 1927, j’ai presente une communication, “ Notice sur
deux manuscrits de mdlecine,” ou j’ai donne quelques informations sur
I’exemplaire, que j’ai considere superieur aux deux meilleures copies
fran^aises.

Reproduisant le Rigime du Corps, il y a un incunable dont les carac-
idistiques sont les suivantes:

(1480 ou 1481) Lyon—(Guillaume le Roy ou Martin Huss) Folio. (78) fl.
Signatures [a*]-l. 2 cols. 33 Is. tip. 5 gravures sur bois.

Fl. 1: Titre.

Fl. I’': Cy commence le liure de / maistre Aldebrandin pour la / sante du
corps garder et de chascu membre pour soy gar/der et conseruer en
sante. (...)

Fl. 2»: Cy finist la table de ce pre / sent liure.

Fl. 3: Cy apres demonstre quest / phisique. \_P'\Our ce que nous auons /
dit (...)

320

AUGUSTO DA SILVA CARVALHO

FI. 78'': Cy finist le Uure que / maistre aldebrandin / fist a la reqste du roy /
de frdce pour la conser/uacion de la sante du / corps hutnain.

Hain 626. Pellechet 420. Osier 210. Klebs 42.1. Gesamtkatalog 857.
Exemplaires: B. N. de Paris, B. Amiens, Glasgow Hunt. M., Ste. Genevieve.

Traductions Italiennes.

Philosomia degli uomini. Trad. Battista Caracino, 1489, Florence, s. tip.

Hain 627. Gesamtkatalog 856.

Exemplaires: B. N. de Vienne, B. Col. de Seville.

- 1491, Florence, s. tip.

Accurti 2. Klebs 43.2.

Exemplaires: Bib. Vatican.

- 1491, Florence (Lorenzo de Morgiani et Jean Petri)

Catalogue du Musee Britannique. Klebs 43. 3.

- 1500, Venise (Lorenzo de Morgiani et Jean Petri)

Copinger I, 627. Proctor 6383A. Cat. Musee Britannique II, 426. Gesamt-
katalog 856a.

Le manuscrit de la Bibliotheque d’Ajuda provint du Couvent de
Necessidades de Lisbonne, appartenant a la Congregation de TOratoire
de Saint Philippe Nery, ou il avait le n®. 1006-19 et la cote 52-VI-35.

Le manuscrit, en velin, dans le meilleur etat de conservation, est relic
en maroquin rouge avec des fers en dorure, du XVIII® si^le, qu’on sup¬
pose avoir ete faits en Italie, format de 280 X 200, avec (3) 138(28 -|- 10)
fls., 2711. c. g., lettres initiales illuminees, notes marginales. Les illuminures
en rouge, bleu, vert, jaune et or, qui n’ont rien perdu de leur eclat d’un
dessin parfait, constituent de vrais tableautins tres utiles pour I’Ethnog-
raphie et I'Histoire de la Medecine.

Les trois premieres feuilles a deux couleurs, non numerotees, sont
occup^ par un index des matieres du texte plus complet, que celui, qui
se trouve apres un court prologue.

FI. (1) : Ci commencent rubriches de la premiere ptie de ce petit liuvre et cou-
cequamet de tout le Uure. (en rouge)

(Apres viennent les feuilles numerotees) :

FI. 1 (En haut) : Primum folium.

(Illuminure avec un encadrement avec des ornements de feuilles, fleurs,
et quelques animaux et representant le Pere Etemel et au second
plan le Paradis.)

(Explicit) : Dieu qui par sa grant puissance tout le monde etabli qw
premierement fist le del. Apres fist les quatre elemens. Cest la terre.
leaue. Lair, et le feu. Si lui pleust que toutes autres chases de la Iwu
en aual feussent faites par la vertu des ms elemens Si comme sont
herbes, arbres oyseau et toutes bestes poissons et hommes. Et fist prc-

Fig. 1.

Frontispicc du manuscrit de la Bibliotheque d’Ajuda.

321

322

AUGUSTO UA Sll.VA CARVALHO

FI. 2:

FI. 4:
FI. 6:
FI. 8':
FI. 10:
FI. 11'’:
FI. 13:
FI. 14:
FI. 16'-:
FI. 18:
FI. 19':
FI. 24'-:
FI. 27:
FI. 34^:
FI. 37'’:
FI. 40:
FI. 44'-:
FI. 45'-:
FI. 47:
FI. 49:

FI. 53:
FI. 55'-:
FI. 59'’:
FI. 61:
FI. 62' :
FI. 64:
FI. 66'-:
FI. 68' :
FI. 70' :
FI. 122:

FI. 128'-:
FI. 138:

FI. 138' :
FI. (14) :

niierement toutes cho.ses. Anicoi.s qu’il 6st honinie et honinie fist il au
dernier a sa semblance pour la plus noble chose et plus noble creature
quil peust faire en terre. Et lui donna la .seigneurie en terre de toutes
les cho.ses (piil avoit preniierement faittes. Et voult que toutes choses
feussent a honinie obeissans jiour ce (|uil est ainsi coniine fin de toutes
choses et coninio (lit Ari.stotc, car Ten soit bicn savoir (|ue fin est la
nieilleur chose en toutes euures. Car pour la fin fait len (juanccs lenfait.
Prologue de physique.

(Les titres suivants sont en rouge)

Dc lair.

Du mangier.

Du boire et premieremeut de leaue.

Du vin.

Dc dormir et de veillr.

Du traueillcr et du reposer.

De baigner.

Dc alter a femme.

Pourquoi on sc doit garder de courroux.

En quel temps et pourquoy ceiicc doit saigner.

Pourquoy on sc doit ventouscr.

Des sanssucs.

Pourquoy on doit user Ic vomir.

Pourquoy et comment on doit garder dc pestitecc et dc corrupcion.
Pourquoy et comment on doit garder son corps en cliascune .raison.
Comment on doit congnoistre les bourgs et les znlles pour dcmcurc.
Comment on doit cheminer par terre et par titer.

Comment la femme grosse sc doit garder.

Comment on doit garder lenfant quand il est ncc. Et coinincnt on doit
ellire la nourrice pour lenfant nourrir.

Comment on doit garder son corps en clta.<!cun aage.

Comment on doit garder les clicveux.

Comment on doit garder les yeulx.

Comment on garde les oreillcs.

Dc garder les dents et les gencives.

De garder Ic 7'isagc et de donner bonne coulciir.

Comment on doit garder Icstomac.

Comment on doit garder Ic foyc.

De garder Ic cuer.

Cy commence la tierce partic qui cnscignc la nature dc toutes choses
conucnables qui conuicne user. (Ce sont les aliments et les condiments)
Cy commence Ic fin® litirc qui pie dc phisonotnic.

Cy fini ce present liure dc phtsonoinie.

Cy commence Ic liure dc ypocras.

Est le liure que Isyprocas enuoyuy a toy eta Ce.uir car long temps . . .
Explicit liber qui dicitur liber ypocratis
(en lettre dififerente et plus moderne)

Ci apres suit le liure Galien.

Si votis voulcz faire piment prenez . .

Une consultation.

Fig. 3.

La saignee.

324

AUGUSTO DA SILVA CARVALHO

FI. (16) : Fiuitur.

FI. (16') ; (Blanche)

FI. (17) : Dc mntido

FI. (26): Sequitur tal)ula dc xii signis.

FI. (26' ) : (Lc.s .signes du Zodiacjne).

FI. (28) : Pro tinna.

Dc calidum serua niodium bibc pquc labora . . .

(Huit feuilles blanches)

(Dans le verso de la suivante, d’autre ecriture plus inoderne) : Pour flux dc
ventre ou meuisson ou souix.

Prcncs plane une ccrvclle dc farine dorge . . .

♦ * *

Roj^^er Pepin sur le manuscrit de Lislionne a ecrit en 1911 :

De ce ins., an sujet du(|uel ilevaient nous parvenir des indications que nous ont
enipeche dc recevoir les recents evenenients politiques du Portugal, nous savons
sculement, grace ii M. Cardozo de Bethencourt, qu’il est une copie e.xecutee au XV*^
siecle.

Nous avons des doutes sur cette opinion de I’ancien conservateur de la
Bibliotheijue d’Ajuda et sans vouloir affirnier que la date du manuscrit
est anterieure, nous rappelons que dans la derniere feuille du manuscrit
on lit d’ecriture difFerente du texte, mais ancienne

Cest la [.vie] Hare que fit fait ct compile par maistre Allehr at [.vie]
de florente a la requeste dc la Coutesse de prouence qni cstoit uiccre
de la Royue de ffrauce de la Royne dalmayn de la Royne daiu/letrc
et la coutesse daujott Et fait compile eti Ian mil ccchj.

Si cette information est vraie, la date du manuscrit serait 1306 ou

Dans le livre de Landouzy et Pejiin on lit sur le manuscrit d.'ll de la
Bibliotheiiue Nationale de Paris,^ ijue la feuille 6 “ ou commence la tra¬
duction du Regime du Corps, est orne d’une jieinture representant Dieu
creant le moude, .ses marges sout enluminees et dans le bas se voient les
vestiges d'une autre miniature malheureusement effacee figurant vraiseni-
blablement des annoiries.” C’est tout a fait la description du frontisiiice
du manuscrit de Lishonne. Or le manuscrit de la BibliothN|ue Nationale
datede 1367, c’est a dire, du XI V** siecle, ce qui concorde avec I’information
de I’exemplaire de Lisbonne.

’ Loc. cit., p. xlvii.

* Loc. cit., p. .xlviii.

RETAIL PHARMACY AS THE NUCLEUS OF THE
PHARMACEUTICAL INDUSTRY

georgp: urdang*

1. Early Bi-:ginnings

It was about two hundred years ago, in the middle of the eighteenth
century, that the heginnings of a i)harniaceutical industry replacing the
traditioJial small scale manufacturing hy the retail pharmacists l)ecame
obvious. Thus when about another fifty years later, in the early nine¬
teenth century, the general conditions in the world at large offered an
oj)|K)rtunity not only to a few industries favored hy special circumstances
or to a few industrialists gifted with .special scientific or organizational
talents hut to an industrial era. the new development found in i)harmacy
a well pre])ared soil.

Not that there had not been large scale production of certain goods
in the time of Greek and Roman anticpiity and in the Middle Ages.
Mass production of mass goods, however, hy mechanized processes and
with the tendency of creating new needs is a child not only of scientific
and technical ])rogress hut of a new ideology. The industrial era is based
on the recognition of the ecpial rights of all men not only as to heavenly
goods hut also as to earthly ones, setting as a new goal that state of
general refinement and welfare of all mankind, not only of a few
privileged classes or individuals, which we call modern civilization.

The large scale ])roduction of earlier times was essentially incidental
and conservative. Modern industrial mass production has been systema¬
tically planned and progressive.

few examples of early large scale ])roduction may illustrate its
incidental character.

It was pharmaceutical large scale production when at the time of
Herodotus, i. e. in the fifth century B. C., a si)ecial greasy clay to he
found on the island of Lemnos and used as an antidote was made up
into round tablets and sold all over the other Greek islands and Greece
proper.' It was large scale production of the same incidental kind when
in the fifteenth and sixteenth centuries A. D. troches of vi|)ers to he used
for the preparation of treacle were manufactured at Venice; when in the

* Director of the American Institute of the History of Pharmacy, Madison, Wis.

'.A Wootton, Chronicles of Pharmacy, London 1910, II, p. 53.

.325

326

GEORGE URDANG

thirteenth century and later some monasteries in Italy, France and (ler-
many prepared distilled waters and perfumes on a large scale; ' and when
a special group of people in some mountainous regions of Germany about
1525 began the manufacture of certain proprietaries, the so-called
Olitaeten.^

These large scale productions meant merely the exploitation of some
local specialty granting to the producers a practical monopoly. For some
time the greasy clay concerned was found nowhere else hut at Lemnos.
The flesh of the ser|)ents living in the territory of the Venetian republic
was thought especially efficient as an antidote. The monastic manufac¬
ture of distilled waters and perfumes was based on the herbs in the
gardens and the forests belonging to the medieval monasteries, and the
‘‘Olitaeten ” industry in the mountains of Thuringia and Saxony owed
its existence to the fact that the trees furnishing the raw material for
the balsams, etc. incidentally grew just in these districts. None of the
large scale productions mentioned created new needs. None of them was
intended to replace local small scale pre])aration of goods.

The first pharmaceutical industrial manufacturing aiming at replacing
the preparation of compounded drugs in retail pharmacies is reported
about 1600, and it is significant that it was the laboratory of a great
pharmacy which became in this way an ancestor of what we call today the
pharmaceutical industry. The smaller pharmacies of and around the city
of Schleswig (Germany) were forced to buy the “ praeparata chymica
and composita ” needed by them from the court pharmacy which was
conducted on the Duke of Schleswig’s account.*

The fact that this early example of pharmaceutical industry remained
singular is due to the cause of its inception. This cause was not a change
in general conditions but merely the egoism of one of the many German
princes of this period and, therefore, the venture was restricted to the
territory under the command of this prince.

It was not much later that in England a pharmaceutical industrial
undertaking developed from retail pharmacy. Here, however, the motive
was not the enrichment of one individual representative of the fading
world of autocracy, but the benefit of an entire professional group and of
the public which it was to serve. The Society of the Art and Mystery of
the Apothecaries of the City of London, incorporated on December 16,
1617, started in 1623 with the preparation of galenicals and chemicals on

* E. Kremers-G. Urdang, History of Pharmacy, Philadelphia 1940, p. SO.

’ Ibidem, p. 430.

* H. Schelenz, Gcschichtc dcr Pharmadc, Berlin 1904, p. 435.

retail pharmacy as nucleus of pharmaceutical industry 327

a co-operative base. The scale of the products concerned was confined
to the members. Only five years later, in 1628, this undertaking acquired
the status of a regular commercial company. In 1703 the Society was
given the monopoly of supplying the English navy with drugs and in
1801 the East India Company decided to buy all drugs and medicines
from the Society of Aixithecaries.® With the change of character of the
Society from a pharmaceutical association to a medical one, the pharma¬
ceutical commercial undertakings of this group gradually lost their basis.

It may be mentioned that this early English example of pharmaceutical
manufacturing as a co-ojierative undertaking of retail pharmacists has
been followed, although much later, in other countries, e. g. in France in
1852 by the organization of the Pharmacic Ccntrale de France,^ in Ger¬
many by the Hageda in 1902,* in the United States by several organiza¬
tions before the end of the 19th century.* As great as the part may be
that these undertakings have played in the providing of the retail phar¬
macists with the drugs etc. they needed—the Phannacie Centralc de
France belongs to the world’s largest pharmaceutical manufacturing and
wholesale businesses—, it has to be stated that the progress in pharma¬
ceutical science and technique and the utilization of this progress within
manufacturing has been initiated almost exclusively by individually
conducted concerns.

Progress of science and technique on the basis of the emancipation of
thought and action of the individual from the restrictions of the feudal
.system, the facilitation of transportation and traffic, and finally the concen¬
tration of capital and power in commerce instead of estates; these were
the three main conditions for the development of the industrial era.
.\mong these conditions, as far as pharmacy is concerned, progress of
science and technique has ranked first.

The fact that retail pharmacy sheltered and cultivated the young
science of chemistry in the eighteenth and the early nineteenth centuries
made the pharmaceutical retail stores and their laboratories in the coun¬
tries concerned the birthplace not only of the pharmaceutical industry but
also of a great part of applied technical chemistry. This scientific and
industrial development took place in England, France and Germany. In
the United States of America the pharmaceutical industry developed

“C. B. Barrett. Society of Apothecaries of London, London 1905, pp. 120, 176.

* E. Kremers-G. Urdang, /. c., p. 66.

’A. Adlung-G. Urdang, Grnndriss do Geschichtc der Dcutschen Pharmasic, Berlin
1935, p. 116.

“ E. Kremers-G. Urdang, /. c., p. 299.

328

GEORGE URDANG

somewhat later and on a different basis. Here too. however, it was retail
pharmacy that took jiart in the start as well as in the growth of this
industry to an amazing extent.

About 1660 the great English chemist Robert Boyle brought a young
German. Ambrosius Gottfried Hanckwitz. to London and established for
his i)rotege a chemist’s sho]) with a spacious laboratory." The latter,
about 1700, developed into a pharmaceutical manufacturing plant of inter¬
national renown. A. G. Hanckwitz, who afterwards took the name of
Godfrey, established a large scale production of phosphorus and is said
to have achieved almost a monopoly in the manufacture of this article.
He furthermore produced ether on a large scale. He did. however, not
restrict himself to the one or the other kind of production. According to
a bill issued by him, Hanckwitz-Godfrey prepared “ faithfully all sorts of
remedies, chemical and galenical ” and paid to his retail business the same
attention as to his manufacturing.

II. The Development in France and in Germany

There is no evidence as to Hanckwitz-Godfrey’s pharmaceutical ante¬
cedents. We do not know whether he had served the pharmaceutical
apprenticeship of 4 to 7 years, asked for in this period from candidates
for mastership in jiharmacy, and whether he was. therefore, what we
w’ould call today a registered pharmacist.

A genuine pharmacist, however, who was registered not only in the
list of the Parisian Maitres d’Apothicaircs (1752) but also in the long
and proud roster of famous scientists of jiharmaceutical origin was the
Frenchman .\ntoine Baume (1728-1804). It is he whom we rightly may
consider as the first retail druggist, making the laboratory of his store
the starting point of an important manufacturing jdant on the basis ot
scientific knowledge and technical skill.

Baume’s technical inventions and improvements, the usefulness of which
he proved in his own factory and made generously known, belong to the
most important incentives of the modern pharmaceutical and chemical
industry. He intrcKluced the hydrometer, and “ Baume’s degrees ” still
bear his name to a multitude of peo])le. He imjiroved the processes of
distillation and gave in 1757 the first definite modern formula for the
preparation of ether (Dissertation sur Vether dans laqnelle on examine dcs
different prodnits dn nielamje de Vesprit de vin avee des acides mineranx).
In his books Elhnens de Dharmacie Theoriijne et Dratiqne (1762) and

* C. J. S. Thompson, The Mystery and Art of the Apothecary, London 1929, p. 266.

330

GEORGE T’RUANG

Manuel de Chymie (1763) he described all the pharmaceutical and chemi¬
cal apparatus and manipulations worked out by him. His manual has
been translated into English (1778), German and Italian and is one of
the classics of the pharmaceutical chemistry.

In 1775 Baume issued a price list of the pharmaceutical and chemical
preparations qtti sc troiivent d Paris, die:: Baume, Apothicairc, Rue
Coquilliere. This list of 88 pages contains about 2400 individual items,
among them alx)ut 400 different preparations which can l)e considered
to be chemical ones. Besides his pharmaceutico-chemical plant Baume
established the first factory for the manufacture of ammonium chloride.

From now on the number of pharmacists enlarging the laboratories of
their stores to factories grew in proportion with the eminent part jdayed
by French and German pharmacists in the development of science.

Of the manufacturing plants growing up from German back store
laboratories at the beginning of the nineteenth century those esi)ecially of
Martius at Erlangen, Simon at Berlin, Trommsdorff at Erfurt and
Wiegleb at Langensalza gained importance. The factory of Joh. Bar-
tholomaeus Trommsdorff was revived by the grandson of the famous
pharmaceutical scientist in 1837 and is still in existence. It was the
manufacturing of alkaloids which young Hermann Trommsdorff made
the sj)ecialty of the revived plant. He was not the only one to do it.
The discovery of morphine and its basic character by the German retail
pharmacist Sertuerner in the early nineteenth century opened not only a
new field of chemical research but also of industrial production, the one
and the other to became a kind of pharmaceutical monopoly.

In France, Joseph Pelletier, after having discovered quinine in collabo¬
ration with J. B. Caventou in 1820, made it the basis of an industrial plant
which he conducted besides operating his pharmacy, and continuing his
scientific research and teaching, while his collaborator Caventou, likewise
a retail pharmacist, research worker and teacher, did not enter the indus¬
trial field but satisfied himself with having the medal of honor concerning
the discovery of quinine reproduced on the stationery of his pharmacy.

Of the many French retail pharmacists enlarging their laboratories to
commercial manufacturing establishments on the basis of practical inven¬
tions, Stanislas Limousin has to be given the foremost place. When he
died in 1886 the American Journal of Pharmacy said in an obituary of
seven lines that Limousin “ originated a number of improvements of
apparatus, utensils and in the administration of medicines, among them
the wafer capsules (cachet dc pain).”

Atn. Jouru. Pharm. 59 (1887) : 544.

retail pharmacy as nucleus of pharmaceutical industry v^31

It is very characteristic that at this time, 1887, the author of this
necrolojjy apparently thought the wafer capsules more imixirtant than
other inventions of Limousin, e. g. his apparatus for the administration of
oxygen and, alx)ve all, the hyinxlermic ampules which he develojied in
following up the ideas of Pasteur, and which he was the first to manu¬
facture on a large scale.” Since then the role of the ampules in medicine
and pharmacy has Ixjcome evident enough to make it sure that the prac¬
tical value of this invention of the retail pharmacist Limousin is greater
than that of his wafer capsules.

In Germany, the time Ixjtween 1814 and 1851 saw the development of
three pharmacy laboratories into plants which still exist and gained inter¬
national importance: E. Merck-Darmstadt, J. D. Kiedel-Berlin and E.
Schering-Berlin.’*

Johann Daniel Riedel, a student of the great apothecary chemist M. II.
Klaproth and since 1814 owner of the ” Schweizer Aix)theke ” at Berlin,
in 1827 started the first German manufacture of quinine on a large scale.
In this attemjit he was not successful. It was in fine chemicals and later
in synthetics that the concern gained prosperity and finally worldwide
recognition. Since 1928 the firm has lM)rne the name J. D. Riedel-E.
de Haen A. G.

In contrast to J. D. Riedel, the young aiK)thecary Heinrich Emanuel
Merck, a student of Trommsdorff, Sjiielmann (Strassburg) and Hermb-
stadt (Berlin) and owner of a pharmacy at Darmstadt which had been
since 1668 and is still in the iX)ssession of his family, succeded in the
large scale preparation of the new plant bases called alkaloids. In 1827,
the same year in which Riedel had started his unsuccessful attempt, H. E.
Merck published the results of his research as to practical methods for
the preparation of morphine, narcotine, quinine, emetine, strychnine and
other plant substances in a brochure entitled “ Cabinet of Pharmaceutico-
Chemical Novelties ” {Pharmacciitisch-Chcmischcs Sovitoeten-Cabinet).
Simultaneously he made known that he had started the manufacture of
these products on a large scale. It may be mentioned that the son and
successor of H. E. Merck, Georg Franz Merck, likewise specialized in
alkaloid research. He is the discoverer of Papaverine.

The extraordinary attention paid to the alkaloids had a practical as
well as a theoretical, if not even philosophical reason. The practical value
of these new substances lay in their undeniable efficiency as medicinal

Rnnie d’Histoire de la Pharmacte 3 (1932) ; 204.

“G. Urdang, Die Deutsehe Apotheke als Keimsellc der Dcutschen Pharmascutisehen
Industrie, Mittenwald 1930.

[SL.

332 GEORGE URDANG

agents. Their tlieoretical importance, however, seemed to be of even
greater l)earing. With the alkaloids apparently the " cjuintessence." the
really and definitely essential contents of the plants concerned had been
found, the isolation of which had l)een the dream of Paracelsus in the early
sixteenth century. It became a dogma that the alkaloids were entirely to
replace the medicinal use of plants, that the impure and unstable vegetable
drugs were finally sujjerseded by pure and stable chemicals gained from
the plants concerned or synthesized. Purity, that was the goal now given
to pharmacy and the pharmaceutical industry.

It was Ernst Schering at Berlin who in 1851 in the lalx)ratory of his
pharmacy l)egan ex})eriments leading to the preparation of chemicals of
hitherto unknown jnirity. Rapidly growing, the plant merged in 1927
with the C'. A. F. Kahlbaum concern, bearing ever since the name
Schering-Kahlhaum A. G., Berlin.

It is characteristic of the dominant ]KKsition occupied by France in scien¬
tific and industrial pharmacy until the h'rench-German war of 1870-71,
that E. Schering as well as H. F. Merck sought the recognition of French
experts for their products. As early as 1830 the Societe de Pharmacie in
Paris recognized the work of II. Iv. Merck by rewarding him with a
golden medal. 'Fhe letter announcing the reward to the recipient bears
the signature of the famous French pharmacist and discoverer of several
alkaloids, P. J. Rohiciuet, who by the way, himself had enlarged the
laboratory of his pharmacy to a pharmaceutico-chemical plant. In 1855
the products exhibited by Schering at Paris were distinguished in a
similar way.

Merck as well as Schering and Riedel-de Haen have finally found their
way to the Lbiited States. The American branches of the German firms
have developed into American concerns hearing here the designation
Merck and Co., Schering Corjioration. and Riedel-de Maen, Inc., respec¬
tively. In 1893, when the German chemical industry participated in the
Chicago world fair and a number of German concerns exhibited their
products for the first time on American soil, the man commissioned with
the official representation by the German government was Friedrich Witte
of Rostock, owner of a retail pharmacy and a plant grown up from the
laboratory of his store. Since the founding of his factory in 1856 Witte
had sj)ecialized in the preparation of peptones and pepsine.

The case of the concern P. Beiersdorf and Company, A. G. at Hamburg
(Germany) offers an excellent example for the development of large scale
manufacture on the basis of close cooperation between physician and

334

GEORGE URDANG

pharmacist.*® It was the aix)thecary Paul Beiersdorf, owner of the phar¬
macy at the sign of Mercur at Hamhurg, who in his laboratory realized
the ideas of the dermatologist Paul Unna and started the manufacture of
special kinds of plaster, ointments, creams and ointment gauzes. On the
occasion of a visit of American druggists in Hamburg in 1926, Dr. Unna
made the following statement: “ I would not have been able to produce
all that became useful for the Beiersdorf concern, yea I would have
indeed not done anything without the pharmacist Beiersdorf. Mr. Beiers¬
dorf is the intellectual originator of all the many preparations and ideas.
I was the physician who had to help him. He, however, was the tech¬
nician who had to help me in order to introduce these ideas into the
world of reality.”

HI. The Development in England

In contrast to France and Germany the part played by the English
retail pharmacists in the development of modern chemistry has not lieen
of special importance. As a matter of fact there w^as about 1800 in Eng¬
land no really consolidated profession of pharmacy. There were ajiothe-
caries with predominantly medical ambitions, who regarded pharmacy
merely as a subordinate menial activity. There were chemists on the one
hand and druggists on the other, and only a very few people who could
be regarded as professional pharmacists. Nevertheless, it was these few
who laid the groundwork for the modern English pharmaceutical indus¬
try. Their early production was based not as much u|K>n scientific dis¬
coveries of their own as upon the realization of the business possibilities
involved.

Of the British concerns which in the early nineteenth century started
large scale production in the laboratories of the pharmacies from which
they originated, some not only still exist but have develoiied into estab¬
lishments known all over the world. They are: Allen and Hanburys,
Ltd., London and Howards and Sons, Ltd., Ilford, both offsprings of the
same retail drug store, namely the Plough Court Pharmacy in London,
established by Silvanus Bevan in 1715; Thomas Morson and Son, Ltd.,
London; *'■ and J. M. Macfarlan and Co., Edinburgh.*®

As far as Allen and Hanburys are concerned, the manufacture on a
large scale grew out of the needs of the big wholesale business connected

Ibidem, p. 30.

** E. C. Cripps, Plotu/h Court, Loudon 1927.

Chemist and Druggist 118 (1933); 687.

^•Ibidem, 116 (1932) : 711.

.EN (1770-1843)
in London

336

GEORGE URDANG

with the retail pharmacy. A reputation of almost a century was at stake,,
and it is characteristic that the scientific endeavor of William Allen who A
l)ecame a ])artner of the old pharmacy in 1795 and started the manufac- f
tnring of chemicals on a commercial scale in ])artnership with Luke '
Howard in 1797, was devoted more to analytical work than to prepara¬
tory exj)eriments. His laboratory became known as a repository of
chemical reagents, a collection of which was exhibited at the National
Institute of Paris, another proof for the then general recognition of
French predominance in chemical science and techni(|ue. h'or a long
time, until about 1870. the manufacturing work of Allen and Hanburys
retained the role of an accessory to the wholesale business, while the
pharmaceutico-chemical large scale production, employing and promoting
scientific progress, was taketi care of by Howards atid Sons, sejjarated
from the old ])harmacy in 1807 utuler the firm Howard and Company. It
is sigtiificant that the most eminent English pharmacognosist. Daniel Han-
bury ( 1825-1875) was a scion of the Hanbury apothecary dynasty and
started his career in the digtiified atmosphere of the pharmacy to which
he was heir.

Although not adding to the long list of the continental pharmaceutical
discoverers of alkaloids. English retail pharmacists with manufacturing
ambitions immediately sensed the im])ortance of these new products. As
early as 1823 the above mentioned Luke Howard manufactured (luinine.
and his son, John Eliot Howard (1807-1884) became one of the world’s
leading cinchonologists. The chemical control of cinchona-bark as a gen¬
erally recognized trade reciuirement is due to J. E. Howard's consistent
endeavor.'"

The apothecary Thomas N. R. Morson. founder of the concern Thomas
Morson and Son, Ltd., who in 1821 accpured a London pharmacy and
immediately commenced manufacturing on the basis of his studies in
France, is said to have been the first to manufacture ciuinine sulfate and
morphine salts on a commercial scale in England in the back room of his
store at 65 Fleet Market. Finally the firm of J. F. Macfarlan and Com¬
pany, Edinburgh, grown up from an Edinburgh pharmacy founded in
1780, claims to have been among the first large scale manufacturers of
alkaloids on the British Isles. The concern has kei)t up this production
as a specialty to the pre.sent.

Of other English pharmaceutical ])lants still in existence that develoi)ed
from retail pharmacy and can be traced back for more than a century, the
following London firms may be mentioned:

Ibidem, 118 (1933 : 676 .

ketaii- pharmacy as nucleus of pharmaceutical industry 337

John Bell & Croyden whose retail place of origin was established in
1798; Burgoyne. Burbidges & Co., Ltd., emerging from a retail pharmacy
founded in 1741; Dakin Brothers, Ltd., founded by W. Bryden, chemist
and druggist, in 1814; May & Baker, Ltd., established by the retail phar¬
macist John May in 1834 in partnership with Messrs. Pickett and Grim-
wade, all of whom had been apprenticed at Ipswich; Savory and Moore,
Ltd., grown up from a pharmacy founded alxjut the year 1780; Squire &
Sons, Ltd., tracing back their origin to a pharmacy established in the
late eighteenth century and purchased by Peter Squire in 1831; Stafford,
Allen & Sons, Ltd., founded in 1833 by Stafford Allen and Charles May,
an Ampthill druggist and herb grower; Wright, Layman & Umney, Ltd.,
whose history goes back to a pharmacy in Ludgate Hill owned by the
chemist and druggist James Curtis at the end of the eighteenth century.

It is significant that many of these retail druggists who develojied into
industrialists were instrumental in the revival of English professional
pharmacy. William Allen and Daniel Bell Hanbury of Allen and Han-
burys, Thomas M or son of Thomas M or son and Son, John May of May
and Baker, John Savory of Savory and Moore, and Peter Squire of
Squire and Sons belonged to the small group of ambitious and courageous
English pharmacists who, in 1841, founded the Pharmaceutical StKiety of
Great Britain that in the course of time became the officially recognized
self governing body of English Pharmacy.

IV. The Development in the United States of America

The North American colonies were, naturally, not able to develop a
pharmaceutico-chemical industry of their owti. The country was thinly
settled, the means of transportation were jxior, and finally and decisively
it was not in the interest of the mother country England to promote or
even to jiermit an industrial development apt to diminish the English
export to the colonies. Thus it was not until the end of the Revolutionary
War that large scale production of pharmaceutical chemicals was started
in this country. It was from the laboratory of a retail pharmacy that this
production developed. The firm of Christopher, J r. and Charles Marshall,
retail and wholesale druggists in Philadelphia in 1786 entered into the
commercial production of ammonium chloride and Glauber’s salt.‘* It is
of interest that the first people to produce ammonium chloride commer¬
cially in Europe, as well as on American soil, the Parisian apothecary
Baume and the Philadelphia druggists Marshall, were retail pharmacists.

**E. Kremers-G. Urdang, l.c., p. 315.

338

GEORGE URDANG

In 1826 the Philadelphia retail and wholesale druggists Samuel P.
VVetherhill and Company advertised in Paulson’s Advertiser preparations
of their own manufacture, among them " Tartaric Acid, Sup. Carh. of
Soda, Rochelle Salt. Calomel, Sulphuric Aether ” and an alkaloidal salt,
“ Sulphate of Quinine.” The credit of having pioneered in the manu¬
facture of alkaloids on American soil, however, has to be given to Euro¬
pean chemists who immigrated into the United States, and not to retail
druggists born and raised in this country. The import of the new Euro-
l)ean pro<iucts was followed by the import of the people who |K)ssessed the
scientific knowledge and technical experience to manufacture them. It
was primarily the firm of Rosengarten and Sons, founded in 1822 by the
Swiss chemist Seitler, and the German chemist Zeitler, which started the
manufacture of alkaloids in the United States of America.

That pharmaceutical industry which grew up from American retail
pharmacy was in its beginning mainly based on galenical prei)arations.
In 1838 the Philadelphia retail druggist Robert Shoemaker successfully
developed a process for making plasters other than by hand and became
a large scale manufacturer of this article. The same man is said to have
been the first in this country to prepare glycerin commercially,‘“ probably
according to the method made known by the most famous retail phar¬
macist of all time, C. W. Scheele, who recognized glycerin in 1783.

The utilization of indigenous drugs play'ed an important part in the
development of the American pharmaceutical industry. The still flourish¬
ing concern of William S. Merrell Company in Cincinnati, offspring of
the retail drug store founded by W. S. Merrell in 1828, has worked suc¬
cessfully in this field and has been followed by many other manufacturers.
The process of iiercolation. invented in France, but owing its development
mainly to American retail pharmacists, became the domain and the start¬
ing point of the manufacturing on a large scale, developing from American
drug store laboratories.

When Frederick Stearns, founder of Frederick Stearns and Co. at
Detroit and a man of great versatility and many talents, started his labora¬
tory in the tiny backroom of the drug store ojKoed b\^ him in 1855, it was
csjjecially fluid extracts which he offered his colleagues."*

When in 1860 the owner of a small Baltimore drug store, A. P. Sharp,
made his clerk Louis Dohme his partner, and the new firm Sharp and

** Ibidem.

J. W. England, The First Century of the Philadelphia Collcue of Pharmacy, Phila¬
delphia, 1922, p. 104.

“ Pharm. Era, 16 (18%): 935.

Fig. 4.

P:LI LILLY (1838-1898)

Druggist in Indianapolis, Indiana
Civil War Colonel

United States of America

339

340

GEORGE URDANG

Dohnie started in the manufacturing business, the prociucts consisted
“ exclusively of official fluid and solid extracts, elixirs, wines, syrups and
some chemicals.” •• There was no pharmaceutico-chemical manufacturing
of greater im[)ortance until 1886 when the firm began the production of
pure plant principles.

When in 1876 the druggist and Civil War colonel Eli Lilly, having
successively owned retail pharmacies at Greencastle. Indiana and Paris,
Illinois, opened the small laboratory in IndianaiM)lis, which was to expand
to the pharmaceutical plant that gained world wide importance under the
name of Eli Lilly and Company, " the line of products consisted of fluid-
extracts. elixirs, syrups, a few wines and the then new li(|uid i)epsine
preparations.” ■*

Of s[)ecial interest are the beginnings of Parke. Davis and Company.
'I'he birthplace of this concern was the small drugstore of an interesting
man. pharmacist as well as physician, who had studied chemistry in Ger¬
many : Dr. Samuel P. Duffield. His ambitions were on the chemical side.
In 1862 he started the manufacture of chloroform, ether and spirit of
nitre, and did not succeed. Success did not come until the early seventies
when the new leaders of the firm, H. C. Parke and George S. Davis,
resolutely devoted their main endeavor to fluidextracts, searching simul-
tanet)usly for new vegetable drugs, and venturing their own botanical
exjHfditions in order to find them. “ The first products manufactured in
the early laboratory.” says E. R. Taylor, " were a few chemicals and a
line of fluidextracts.” Taylor gives a list of not less than forty-nine
drugs, the fluidextracts of which were put on the market for the first
time by Parke, Davis and Company. It was the fluidextracts which by
the same concern in 1879 were made the first pharmaceutical ])roduct to
l)e submitted to a new and revolutionary procedure, that of standardization.

The process of {XTColation was developed by American retail phar¬
macists as a result of their practical professional skill. It was on the
same basis that they develo|)ed a new industry by inventing new processes
and improving old ones for the preparation of products hitherto manu¬
factured in a rather primitive way and with primitive results.

When in 1862 the graduate of the Philadelphia College of Pharmacy,
John Wyeth, decided to enlarge to a pharmaceutical plant the laboratory
of the pharmacy conducted by himself and his brother, F. II. Wyeth, on
Walnut Street, Philadelphia, he too started with fluidextracts, wines.

*’ Ibidem, p. 920.

** E. Kremers-G. Urdang, l.c., p. 320.

** Journ. Am. Pharm. Assoc. 4 (1915) : 4C9.

RETAIL PHARMACY AS NUCLEUS OK PHARMACEUTICAL INDUSTRY 341

svrups and elixirs. What, however, made John Wyeth and Brothers,
Inc., Philadelphia, Pa., important in the history of the American pharma¬
ceutical industry is the fact of their early interest in the large scale manu¬
facture of tablets. Although the distinction to have been the first to start
the manufacture of “ compres.sed pills” (tablets) in the United States
apparently rests with Jacob Dunton, a wholesale druggist in Philadelphia
(in the early sixties of the nineteenth century), it was the production
which John Wyeth and Brother, Inc., commenced about 1872 which made
this tyi)e of drug administration popular in this hemisphere. Further¬
more, according to Lyman F. Kebler the world seems to be indebted to
the brothers Wyeth for the very term “ compressed tablets.”

“ Every indication tends to show.” Lyman states, “ that the term ‘ com¬
pressed tablets ’ had its origin in the United States and that John Wyeth
and Brother were the originators of the name. Registered trade marks
No. 1001 and 1002 were issued to that firm on March 13, 1877, covering
the term.”

It was after having worked with John Wyeth and Brother for three
years that the pharmacist, Silas M. Burroughs, in 1880 caused his friend
and colleague, Henry S. Wellcome, to join him in founding at London,
England, the pharmaceutical plant of Burroughs, Wellcome and Co.,
whose “ tabloids ” have become known all over the world. It is of in¬
terest that the thesis with which the young student, Burroughs, gained
in 1877 his degree as a Graduate in Pharmacy at the Philadelphia College
of Pharmacy was devoted to " The Compressiotl of Medicinal Powders.”
Since neither S. M. Burroughs nor H. L. Wellcome ever owned an
apothecary shop, their firm cannot be added to the list of pharmaceutical
plants that developed from the laboratories of retail pharmacies.

Even if the “ compressed pill ” was conceived by a non-pharmacist, the
English mechanician, William Brockedon (1843), and only taken over,
improved and made popular by pharmacists, there was one special type
of “ elegant pharmaceutical product ” (as the modern convenient prepara¬
tions were called by their manufacturers) which in concept as well as in
materialization was entirely due to the inventiveness and technical skill
of an .American retail druggist: the sugar-coated pill. The sugar coated
pills, invented in 1856 by the Philadelphia druggist. William R. Warner,
in the laboratory of the retail pharmacy bought by him the same year,
have like the tablets weathered all changes of a rapidly changing world.
In 1879 the same man introduced the so-called parvules, very small pills
which could be produced only by means of special apparatus."" When in

’’'Ibidem, 3 ( 1914 ) : 844 .

’* Pharni. Era 16 ( 1896 ): 941 .

342

GEORGE URDANG

1931 the firm of William R. Warner & Co., Inc., celebrated its seventy-
fifth anniversary, it was able to state that the small laboratory of 1856
has grown into a world organization with branches dotting the map of
the world.

A comparatively late development of an early American drug store is
represented by the Strong, Cobb and Company concern in Cleveland,
Ohio. As early as in 1833 the druggists Henderson and Punderson
founded a drug store in the then small Middle West settlement. In
1850 the druggists Strong and Armstrong acquired and enlarged the
store. In 1870 the druggist Ahira Cobb joined the firm and a wholesale
drug department was added. Finally in 1888, more than fifty years after
the founding of the retail pharmacy that had formed the nucleus of the
expanding business venture, a true pharmaceutical and chemical laboratorj-
was established.'^

In recent years the opinion has been voiced that in our time of con¬
centration of capital and of the power which it means, there is no longer
any opportunity for the development of an industrial plant out of a retail
pharmacy. The concern of Hynson, Westcott and Dunning at Baltimore
is an excellent proof to the contrary. A retail pharmacy established in
1889 on an exclusively scientific and professional basis, the firm entered
the field of large scale production in consequence of the research work of
one of its owners, Henry A. B. Dunning in 1910, and belongs today to
America’s best known representatives of the pharmaceutical industry.

This example can be supplemented by another one in which commercial
genius rather than scientific ambition made a modern American drug store
the vantage ground of a startling career.

On September 2, 1942, there died at Petoskey, Michigan, from injuries
suffered in an automobile accident, a man who for decades had been a
figure of international prominence in pharmaceutical manufacture: Wil¬
liam E. Weiss, the co-founder and chairman of Sterling Pnxlucts, Inc.
The ground from which this man rose to the heights of big business and
finance was a retail pharmacy opened by him in 1900 in the town of
Wheeling in West Virginia. In 1901, in association with his life-long
partner, A. H. Diebold, who like him was a native of Canton, Ohio, he
founded in Wheeling the pharmaceutical manufacturing company which
Itecame Sterling Products, Inc., and in an amazingly short time acquired
the control over (juite a number of well known pharmaceutical manufac¬
turing establishments, the Bayer Co., California Fig Syrup Co. (Castoria)

Helen M. Focke. Cleveland's Chemical Pioneers of the Nineteenth Century, Chcm.
and Engin. Nev's 22 (1944) : 244.

retail pharmacy as nucleus ok pharmaceutical industry 343

and Charles H. Philipps Chemical Co. Mr. Weiss was also active in the
development of the Winthrop Chemical Co., H. A. Metz Laboratories,
and Alha Pharmaceutical Co.’*

V. The Proprietary Industry

There is one phase of pharmaceutical industry that has not yet been
given special attention in this survey, the manufacture of proprietaries.
It has to be stated that only a part of the early proprietaries which became
famous in the seventeenth and eighteenth centuries was invented and
brought on the market by retail pharmacists. These arcana were pro¬
duced by physicians, (juacks, and jjeople of the most different walks of life,
at least to the same extent as by pharmacists.

It has been France, where in the seventeenth and eighteenth centuries
retail pharmacy has contributed the greatest part to the proprietary indus¬
try and has continued to do so up to the present. In a report to the
American Bureau of Foreign and Domestic Commerce at Washington,
David S. Green, then American Assistant Trade Commissioner at Paris,
pcjinted out in 1926 that “ outside of a few very large firms the French
prepared medicine industry is made up of countless small manufacturers,
each of whom sjiecializes in one or two remedies,” and that “ fully fifty
percent of the licensed pharmacists in France are engaged in this business,
most of them in a small way.”

In Germany, England and the United States of America the part of
retail jiharmacy in the proprietary industry has not lieen as large. Retail
pharmacists, naturally, have always and in all countries of the world pre¬
pared some products of their own composition and sold them to their cus¬
tomers. Only a few of these preparations, however, have found their
way to the general market. Retail pharmacy has lieen the nucleus of the
pharmaceutical industry based on scientific development, technical skill
and new methods of preparation. It has not been the cradle of the indus¬
try of proprietaries, the contents and real nature of which have been held
secret. On the contrary, it was retail pharmacists in France as well as in
England, the Lemery, Charas, Caspar Neumann, M. H. Klaproth, Her¬
mann Hager and others who from the eighteenth century to the present
day made it their task to reveal the secrets of proprietaries the claims of
which they thought unjustified. It was, finally, an American concern
grown up from retail pharmacy that conceived the idea of replacing the

Phil. Coll. Pharm., 34 (1942), No. 5.

“* American Druggist, 74 (1926) : 17.

344

GEORGE URDANG

proprietaries of secret composition by “ non secrets.” In 1876 the con¬
cern already mentioned. Frederick Stearns and Co., Detroit, created the
so-called “ ethical specialty ” with published formula on the label. At
j)resent the preparation of such ” ethical siiecialties ” forms an important
part of the pharmaceutical industry, and the principle underlying it has to
some extent found its confirmation by the United States Food, Drug and
C'osmetic Act of 1938 and similar legislative acts in other countries.

VI. Conclusion

There cannot be any doubt about the important part retail pharmacy
has played in the development of the pharmaceutical industry. What,
however, is behind all the facts reported above and what do they mean to
the body pharmaceutics as a whole, consisting of retail as well as manu¬
facturing pharmacy? There are three platforms from which these ques¬
tions can be considered and answered, and all of them are equally
imjHjrtant: that of scientific progress, that of general economics, and that
of professional retail pharmacy.

The scientific progress brought about by and continuously resulting
from the industrialization of the production of drugs cannot be denied.
The discovery or invention of new and important products and of methods
of preparation has often been the work of some especially gifted indi¬
viduals and, as has been shown in this survey, many retail pharmacies con¬
ducted by such individuals have become the nucleus of industrial produc¬
tion. The establishments, however, into which these back store labora¬
tories finally develop, find themselves in quite another atmosphere than
that of retail pharmacy and are subjected to quite different principles of
conduct. The retail pharmacist as an inventor or discoverer becomes
either an industrialist himself, or he and his research activities and results
become utilized by one of the manufacturing plants already in existence.
He becomes a link in the purposefully planned industrial research of today
that, effected on a large scale and employing all people and all resources
available, nowadays deprives even the genius of his splendid isolation and
makes him and his work a part of co-operative endeavor.

Since extraordinarily talented individuals are rare in pharmacy as they
are in all other professions, more cannot be asked from the bulk of the
retail pharmacists than the conscientious and intelligent employment of
the science and technique of their profession within the retail practice of
pharmacy. That retail pharmacy can be considered as an especially fertile
ground for the development of talent and skill has been proved in this
survey.

KETAII. PHARMACY AS Nl'CLEUS OK PHARMACEUTICAL INDUSTRY 345

As far as the consideration of the pharmaceutical industry from the
point of view of general economics is concerned, it has to be borne in
mind that most modern economists regard the big concern with its large
nuniljers of employees, as well as of turnover, as the unavoidable culmina¬
tion if not even the goal of modern capitalism, because the highest possible
economic effect can be reached only by organizational concentration and
rationalization of capital and labor, extensive advertising and exertion of
control of and influence upon the market. Under this aspect small busi¬
ness is nothing but a preliminary stage of development unless it is indis¬
pensable tiecause of the part it plays as a fitting and distributing agency.
The fact that in spite of the extraordinary development of industrial
production of pharmaceuticals, grown up to a very great extent out of
retail pharmacy, the latter during this period has not decreased but
increased in volume as well as in importance in all countries of the civilized
world is an economic phenomenon. It can be explained only by two other
facts. First, the pharmaceutical industry has created new needs to the
advantage of retail pharmacy. Second, retail pharmacy has proved to be
indispensable and irreplaceable as the fitting and distributing agency of
the products concerned. There is a limit to mechanizing and schematizing
in medicine and in pharmacy. Between the individual physician and the
individual patient, the individual pharmacist cannot be missed.

Finally the question of what the pharmaceutical industry has given to
and what it has taken from pharmacy has to be answered. Doubtless
industry has taken over almost completely the manufacturing earlier
executed by retail pharmacy. As far as the galenicals are concerned,
retail pharmacy and not industry has to be blamed. As a matter of fact,
the opinion that industry has robbed retail pharmacy of its manufacturing
activities is wrong because the latter partly left it voluntarily to industry,
and because, and this is even more important, the industrial products very
often represent new creations or specialties, the preparation of which is
not within the means of an average retail pharmacy.

The new synthetics, alkaloids and glucosides have merely replaced the
old “ simplicia ” of botanical, animal or mineral origin now more or less
obsolete, and it does not mean any change of principle in retail pharmacy
that in filling prescriptions or in preparing “ composita" the modern retail
pharmacist uses mostly ingredients of chemical origin. On the contrary,
the incorporation of these new " siniplida” into adequate modes of appli¬
cation re([uires at least as much skill as the pharmacist of old had to
possess, and certainly more knowledge.

The case is different so far as the ready made proprietaries are con-

346

GEORGE URDAXG

ccrned, leaving to the retail pharmacy only the role of a transit trade
agency. Here the decisive question is whether these proprietaries meet
the requirements to be fulfilled by a good and decently priced remedy or
not. If they do not, then they have to be eliminated or their trade has at
least not to be promoted. If they do, then it has to be Ixirne in mind
that each real enrichment of the materia medica is of advantage not only
to the public but also to the agency which distributes it to the customer.
Each efficient remedy strengthens the confidence of the public iit remedial
therapy in general, and in the distributing agency, i. e. retail pharmacy, in
particular.

The above list of pharmaceutical plants grown up from the laboratories
of retail pharmacies is far from being complete. Only examples thought
to be typical have been given. Plants that have ceased to exist have been
mentioned merely in a few exceptional cases. Furthermore, pharmaceu¬
tical houses that have devoted themselves to the wholesale business pri¬
marily although doing a good deal of manufacturing, as for instance the
renowned New York firm Schieffelin & Co., the offspring of the drug
business established by Effingham Lawrence at New York in 1781, have
not been included

Would completeness have been attempted the list would have become
much longer. It would have become endless if those pharmacists would
have been included who made important inventions or discoveries without
entering the field of industry or who founded industrial plants or served
in industry w’ithout having been owners of retail pharmacies.

The idea was to show how retail pharmacy, how the “ store ” became
the nucleus of the pharmaceutical industry in the great industrial coun¬
tries in a decisive period, in a decisive way, and in almost all its phases.

The pharmaceutical industry has doubtless enriched and in some respect
even educated retail pharmacy. It was on the other hand retail pharmacy
which has given and continues to give many of its best men to industrial
pharmacy. Manufacturing and retail pharmacy are two branches of the
same tree. They belong together, they work together, and their com¬
bined effort is directed towards the same aim: to furnish medicine with
the best possible armament in the eternal fight against disease and for the
betterment of health.

INDEX OF NAMES

d’Abano Pietro, 13, 203, 242

Abascal, Fernando de, 264

Abbott, Maud, 157, 159

Abel, Niels Hendrik, 212

Abraham, 77

Abul Qasim, 203

Ackerknecht, Erwin H., 16-31

Acosta, Padre Joseph de, 138-139, 144

Addison, Joseph, ^4

Adlersberg, 167, 169

Adrian, Roman Emperor, 170

Aesculapius, 13, 74, 76

Aetius, 107

Ag^ippa von Nettesheim, 225
Alberti, Giovanni de, 10, 203
Albertus Magnus, 203
Albinus, 116
Albunar, Lopez, 138
Alcala de Henares, 132
Aldebrandino, 318-324
Alegre, Pedro, 182
d’Alembert, 286, 293
Alexander I, Tzar of Russia, 306
Alexander III, Pope, 240
Alexander, Elizabeth H., 66
Alexander the Great, 252, 254
Alfonso, Rey D., 265
Ali ibn Abbas, 203

Ali ibn Yusuf (Haly filius Joseph), 185

Allen, Fr., 161, 167-169

Allen, Stafford, 337

AUen, William, 335-337

Alston, Charles, 106

Alvarado, Jorge de, 180

Amman, Jost, 274-276

Ampere, Andre-Marie, 210

Amphiction, 78

Amusco (Juan de Valverde), 132

Anchieta, de Jose, 182

Anglicus, Bartholomaus, 223

Anglicus, Gilbertus, 223

Angjicus, Joannes, 223

Anitschoff, Nikolai, 158, 159

Ann, Queen of England, 55

Anna, Contessina Barnaba Barbo, 288

Anthony, Francis, 224

Apis, 74

Apollo, 74, 76, 78
Arabus, son of Apollo, 74
Arceo, Francisco, 132
Archagathus of Peloponesus, 74
Arcieri, G. B., 36
Aretaeus, 115
Argellati, Filippo, 188
Arghun Khan, 254
Aristotle, 203, 213, 215
Armstrong, 342
Arnold of Villanova, 203
Arriaga, 138, 139, 142, 143, 145
Arrillaga, Francisco C., 157, 160
Aschoff, Ludwig, 156, 159
Ascoli, Alberto, 32-42
Asoka, Emperor, 170
Assmann, Herbert, 158, 160
Aubert, 305

Auenbruggef, Leopold, 52, 154, 159
Augustus, 14
Averroes, 45

Avicenna, 45, 76, 203, 238
Avogadro, Amadeo, 209
Ayerza, Abel, 45, 156
Azara, Felix de, 214

Babini, Jose, 205-206, 214

Babini, Rosa D. de, 214

Bacon, Francis, 225, 226, 230, 234

Bacon, Roger, 245

Baer, Carl Ernst von, 212, 231

Baglivi, Giorgio, 50

Bailly, 26

Bairo, Pietro, 203

Baldelli, Francesco, 73

Bang, 164

Banister, John, 223

Band, Guido, 157, 159

Banting, F. G., 168

Baquijano, Jose, 264

Barbaroux, 26

Barbillon, L., 133

Barduzzi, Domenico, 11

Barthez, 210, 311, 314-317

Bartholomew, 239, 240

Basch, Sigmund v., 156, 160

Bassi, Agostino, 35, 36, 39

347

j !

348 INDEX OF

NAMES

Bastian, 17

Bohn, Johann, 229-231

Bate, William, 231

Bolyai, Jan, 212

Baume, Antoine, 328-330, 337

Bonaparte, 93

Bausch, Johann Lorenz, 226

Bond, Phineas, 112, 114

Beatriz, Comtesse, 318

Bond, Thomas, 112

Beauhamais, Prince Eugene, 94, 101

Bonesans, Gian Saverio, Marchese di

Beecaria, Cesare Bonesana, 283-308

Beccaria, 283

Beccaria, Giulio, 287, 288, 305

Bongert, I., 33, 34

Beecaria, Maria, 288, 289

Bordet, Emile, 157, 160

Beck, Charles S., 159, 160

Bordeu, 311

Beiersdorf, Paul, 334

Borelli, 23

Beltran, Juan Ramon, 43-47

Borges, 182

Bence-Jones, Henry, 33

Borromeo, Cardinal Federico, 302

Benzi, Ugo, 9

Botallo, Leonardo, 154, 159

B^rard, Frederic, 309-317

Bouchardat, 161, 162, 164, 167, 169

Berengario, Jacc^, 11

Bouguer, 23

Berenger IV, Raymond, Comte de Pro¬

Bouillaud, Jean Baptiste, 154, 160

vence, 318

Bouveret, Leon, 156, 160

Berger, von, 231

Boyer, Simon, 19, 20

Bergey, 32

Boyle, Robert. 23, 56, 227-230, 233-234.

Bergmann, 19

Brachet, 23

Bergson, H., 17

Bramante, 1

Berillon, 19, 22

Brambilla, Giovanni, 11

Berlin, David, 159, 160

Brand, 230

Bernard, Claude, 17-20, 22, 28, 45

Brandeis, H., 96

Bert, Henrietta, 20

Brauell, 33-35

Bert, Ltonie, 21, 27

Brauer, Ludolph, 158, 160

Bert, Paul, 16-31

Braun-Menendez, Eduardo, 159, 160

Bert, Pauline, 20

Braz Cubas, 181

Berthelot, Marcelin, 17, 18, 20, 23, 26,

Bretonneau, 125

Briggs, William, 229, 230

Bertrand, J., 12

Bright, Richard, 154

Best, C H., 168

Brissot, 26

1 i Bethencourt, Cardozo de, 324

Broadbent, William H., 156, 160

; ' Bethencourt, Hermano Pedro de, 174,

Broca, Paul, 146

i j 177, 178, 182

' Bevan, Silvanus, 334

Brockedon, Wm., 341

Brown-Sequard, C. E., 19

Bichat, Marie-Franqois-Xavier, 309, 312

Browne, Sir Thomas, 236 I

Bilger, 230

Bruce, 32 1

Billroth, Theodore, 17, 19

Brugnoli, 37 i

Bixio, 26

Brunet, 187 i

Blackmore, Sir Richard, 55-57, 61

Brunhaut, Queen, 91 I

Blanqui, 18, 26

Brunner, J. C., 228, 229, 231, 233

Blasco, Teresa, 283

Brunschwig, Jerome, 223

Blaudin, Victor, 26

Brunton, Thomas Lauder, 155, 159 S

Blum. L., 165

Bryden, W., 337

Blumgart, Herrman L., 158-160.

Buchez, 26 ;

Boas, F., 18

Buerger, Leo, 157 e

Boerhaave, Herman, 11, 106, 107, 115,

Buflon, 293 [

116, 125, 126

Bulloch, William, 35, 36, 39, 41

Bogaert, Adalbert v., 159

Bunge, Mario, 207, 214

INDEX OF NAMES

349

Burroughs, Silas M., 341
Burton, 146

Cabanis, 309

Cabot, Richard C., 157, 159
Cacci, Giambattista, 1^

Cadwalader, Thomas, 112
Calabresi, Masimo, 48-54
Calas, Jean, 286, 287, 291
Caldani, Leopoldo Marcantonio, 11
Calpitanus, 76
Camascca, 140
Cambon, 31

Cannizzaro, Stanislao, 209
Cantani, 161-164
Cantu, Cesare, 305, 306
Capac, Manco, 140
Capdevila y Casas, E., 14
Caras, 78

Carbonelli, G., 4, 188
Cardano, Gerolamo, 13
Cardarelli, Antonio, 155, 160
Carnot, Sadi, 18, 210
Carrel, A., 21
Carson, James, 37
Casas, Juan Antonio de las, 306
Cassius, 76

Castellanos, Alfonso, 159, 160
Castellino, P., 38

Castiglioni, Arturo, 35, 37, 66, 87-89,
203, 216, 236, 266.

Castiglioni, Laura, 4
Castiglioni, Mme., 4
Cathrall, 260
Cato, Marcus, 76, 77
Cauchy, Augustin-Louis, 212
Caventou, J. B., 330
Caylay, 37

Cellini, Benvenuto, 10
Celsus, Aulus Cornelius, 14, 76, 107, 111,
115, 123, 203
Centa, Jordan B., 215
Cervantes, Miguel, 55-61
Cesalpino, Andrea, 154
Cesar, 322
Cezanne, Paul, 18
Charas, 343

Charcot, J, M., 17, 18, 27
Charles II, King of England, 225
Charles III, King of Spain, 264
Charles IV, King of Spain, 261

Charles V, King of Spain, 87

Charleton, Walter, 225, 228, 230

Chauveau, Augiiste, 155, 159

Cheyne, John, 125, 154, 160

Chimpu, Ocllo, 141

Chiozza, Luigp, 36

Chiron, 76

Chittenden, 167

Christ, 100, 298

Cicero, 3, 78

Cieza, 144

Cigna, 23

Clarke, 227

Clayton, Josephine, 20

Clemenceau, 26

Clemens XI, Pope, 48

Clement, 74, 78

Clopton, 233

Qowes, William, 223

Cobb, Ahira, 342

Cobb, de, 145, 148

Cocachin, Princess, 251

Cohn, Ferdinand, 35

Cohnheim, Julius, 18, 155, 159

Coignard, Jerome, 38

Colet, 79

Collins, 228

Columelle, 100

Combes, 26

Compostela, Avelino de, 182
Condillac, 309
Condorelli, Luigi, 159
Conring, Hermann, 227
Coray, Diamant, 306
Cordus, Valerius, 230
Corradi, 4

Corrigan, Dominic John, 154, 160
Corsini, 4

Cortez, Hernandez, 172, 173, 180

Corvisart, Jean Nicolas, 154, 160

Cossi, Pedro, 159

Courtet, 17

Cowper, 228

Cristobal de la Vega, 132

Croce, Benedetto, 216

Crookshank, F. G., 90

Cruz, Fray Rodrigo de la, 177

Cullen, 312

Culpeper, Nicholas, 230
Cuneus, 14
Curtis, James, 337

350

INDEX OF NAMES

Cushing, Harvey, 2, 14
Cusi, Huallpa, 140
Cuvier, Georges, 212-213
Cyon, Ilia de, 22, 155

Dalton, Jcdin, 209
Dante, 9, 242
Darwin, Charles, 213, 214
Dastre, 22, 30
Davaine, C., 33-35
Davila, Antonio, 182
Davis, George S., 340
Davy, Hiunphry, 209, 210
Daza Chacon, 132
Degas, 18

De Giovanni, A., 63
Delphus, 78
Democritus, 77
De Renzi, S., 4, 185, 188
Descze, 311, 314
D’Harcourt, Raoul, 180
Diderot, 293, 306
Diebold, A. H., 342
Digby, Sir Kenelm, 225, 230
Dino di Garbo, 203
Dios, Juan de, 177
Dioscorides, 77, 203, 256
Dohme, Louis, 338
Donkin, 165
D’Orbigny, 214
Dostoyevski, 306

Draghetti, Bartolommeo, 187-188

Dressier, Wilhelm, 159

Dreyfus, 28

Ducoux, 26

Dueling, 165

Duffield, Samuel P., 340

Duhem, P., 17

Dumas, 311, 317

Dunning, Henry A. B., 342

Dunton, Jacob, 341

Duroziez, Paul Louis, 155, 160

Eberth, K. J., 19

Edelstein, Ludwig, 55-61

Edens, Ernst, 159, 160

Edward VI, King of England, 80

Ehrlich, Paul, 17, 40

Einthoven, Willem, 52, 152, 156, 160.

Eisenmenger, Victor, 156, 160

Ekaterina II, 294, 302

Eleazar, 77

Elias, Herbert, 158, 159

Elizabeth, Queen of England, 81, 223
Ellis, H., 80

Elsholtz, Joh. Sigmund, 228, 229

Emilius, Lucius, 74

Empedocles, 77

Ent, Sir George, 230

d’Este, Leonello, 199

Estevez y Borges, Nicolas, 182

Ettmuller, Michael, 228, 234

Eusebius, 77

Eustachius, B., 48

E)rmeric, Nicholas, 289, 293

Eyzaguirre, Gonzalo, 149

Fabiola, 170
Fabricius, 228
Fabry of Hilden, 235
Facchinei, Father Ferdinando, 287, 291,
293

Fallopius, G., 14

Fallot, Etienne L. A., 156, 160

Falta, 165

Faraday, Michael, 210

Farfan, J. M. B., 134

Fehr, Joh. Mich., 226

Feldman, 41

Feller, Adolf, 158, 159

Ferdinand, Archduke, 302

Ferdinand II, Emperor, 226

Ferguson, John, 68-70, 72, 88.

Fernet, 23

Ferrj', Jules, 18, 30

Fester, Gustavo A., 214

Feyerabend, Sigismund, 274, 275, 276

Ficino, Marsilio, 203

Figueroa, 182

Filippineo, Francesco, 187, 190
Finlay^ Carlos J., 39, 261
Firmian, Count Charles, 287, 288, 291,
292, 294

Fischer, Isidor, 14, 267
Fitzroy, 214
Flack, Martin, 157, 159
Flammarion, Camille, 18
Flaubert, 17
Flint, .\ustin, 155, 160
Floridus, Macer, 203
Fludd, Robert, 224, 225
Foa, Carlo, 62-64
Foligno, Gentile da, 203
Folin, 164
Forestus, 110

Forlanini, Carlo, 37, 63, 64

INDEX OF NAMES

351

Foster, M., 18

Foster, William, 225

Fothergill, John, 103, 104, 114, 125-128

Fouquet, 311

Fourcroy, 26

Fourier, Joseph 212

Fox, Abraham Lenertzon, 79, 224

Fracastoro, Gerolamo, 10, 11, 204

Fraenkel, Albert, 157, 159, 160

Fragoso, 132

France, Anatole, 34, 38

Francis, W. W., 87

Francisco de Toledo, 131

Frank, Otto, 157, 160

Fraunhofer, 211

Fredericq, Henri, 158, 159

Frerichs, 163, 169

Fresnel, Augustin, 210

Freud, S., 17

Freund, W. A., 19

Frias, Garcia, 149

Friedlander, 39, 40

Fries, Lorenz, 223

Frisi, Paolo, 286

Frothingham, 41

Fulton, J. F., 16, 65-88

Fusil, 64

Gabon, 309

Gabriel, Marques de Aviles, 261, 262
Gaddesden, John of, 203, 223
Galdston, lago, 89-102 ^

Gale, Thomas, 223

Galen, 45, 65, 76, 107, 109, 128, 184,
190, 191, 202, 203, 238, 257, 322
Galileo, 14. 292
Gallavardin, Louis, 158, 160
Gallieni, 31
Galois, Evariste, 212
Galvagni, Ercole G., 155, 160
Galvani, L., 52
Gambetta, Leon, 18, 21, 27
Gante, Fray Pedro de, 180
Garces, Fray Julian, 181
Garcilaso de la Vega, 131, 133, 140, 141,
143, 151

Garrison, F. H., 22, 137
Gasquet, F. A., 87
Gaub, J. D., 116

Gauss, Johann Friedrich, 211, 212
Gay-Lussac, 209

Genovesi, Antonio, 288

George I, King of England, 55

Georget, 309

Gerraris, Galileo, 64

Ghiberti, Lorenzo, 9

Giannone, A., 292

Gidon, F., 12

Gildas, 79

Giordano, D., 4

Glandorp, 236

Glauber, Johann Rudolf, 234

Glisson, F., 228, 230, 231, 233

Goclenius, Rudolf, 225

Godfrey (see Hanckwitz, A.)

Godoy, Manuel de, 261

Goedeke, Karl, 268

Goethe, Wolfgang, 12

Goldblatt, Harry, 159

Golgi, C., 64

Gollan, Josue, 214

Goncourt, 17

Gonzalez, Vera, 146, 147

Gonzalez Soltero, Bartolome, 182

Gossouin, 239

Graesse, 187

Grafe, 166

Grafton, Richard, 70, 75
Gram, Christian, 39, 40
Grassi, G. B., 32, 36, 38, 64
Gratiolet, 20, 25
Green, David S., 343
Greenwood, Major, 90, 99, 100
Gregory XIII, Pope, 69
Greifswald, 104
Grimaud, 311
Grimm, Jacob, 268
Grimwade, 337
Grocco, Pietro, 156, 160
Grocyn, 79

Grollman, Arthur, 159, 160
Gross, Robert E., 159, 160
Guainerio, Antonio, 203
Guaman, Poma, 131, 133, 134, 138-140,
143, 148, 151
Giiemes, Luis, 45
Guiard, 147
Guillotin, J. I., 26
Guizot, 21

Haeckel, Ernst, 18
Hager, Hermann, 343

352

INDEX OF NAMES

Hales, Stephen, 52
Haller, Albrecht von, 97, 226, 231
Hamer, Sir William, 90
Ilamsing, Hermann, 268
Han, Weygand, 71
lianbury, Daniel B., 336, 337
Hanckwitz, Ambrosius Gottfried, 230,
328

Hanna, James, 218
Harder, 233
Hardy, Thomas, 18
Harris, Walter, 235

Harvey, William, 154, 159, 226, 227,
230, 231, 233
Havers, Clopton, 228, 233
Heberden, William, 125, 154, 160
Helmholtz, Hermann Louis Ferdinand
von, 17, 210
Helvetius, H., 283, 293
Henderson, 342
Henle, Jacob, 99

Henry VII, King of England, 65, 79, 80
Henry VIII, King of England, 65, 79,
81, 82, 84, 87
Herard, 37
d’Herelle, 41
Hering, Hans, 158, 159
Hermanns, Philippus, 224
Hcrmbstadt, 331
Herrick, James B., 157, 160
Herschell, Sir William, 211
Hester, John, 223, 224
Heymans, Charles, 159
Highmore, N., 228, 230
Hippocrates, 11, 44-46, 56, 57, 74, 77,
89, 96, 97, 99, 107, 110, 111, 115, 117,
119, 121, 122, 203, 226, 322
His, Wilhelm, jr., 156, 159
Hitchcock, F. A., 25
Hochrein, Max, 159
Hodgson, Joseph, 154, 160
Hodler, 18
Hofler, Max, 268
Hoffmann, Friedrich, 163, 234
Hofman, Caspar, 226, 227
Holbach, 293
Ho(^e, R., 229
Hoppe, 23
Horace, 94
Horst, Daniel, 227
Hosanna, Samuel, 91

Hosthanes, 77
Houghton, 37
Howard, John Eliot, 336
Howard, Luke, 336

Howard, Thomas Earl of Arundel, 226

Hrdlicka, Ales, 145, 146

Huchard, Henri, 156

Humboldt, Alexander von, 213, 214

Hume, Edgar Erskine, 171, 293

Hutton, Charles, 91

Hutton, James, 213

Hutyra, F., 33

Huxham, John, 103, 104, 125-128
Huxley, Thomas A., 17, 18
Huygens, Christian, 210

Ibn Roshd, 203

Ibn Sina (see Avicenna)

Ibn Zohr, 203
Ibsen, Henrik, 17
Ingenhousz, J., 212
Isaiah, 249
Isaq, the Jew, 203
Isidore of Seville, 69, 239

Janet, P., 17
Janos, Tarnai, 308
Jimenez, Diego, 182
John, Prester, 240
Johne, 41

Johnson, Samuel, 55-57

Jonnesco, Thomaso, 158, 160

Joseph, son of Jacob, 78

Josephus, 77

Joule, James P., 210

Jourdanet, Denis, 21-24

Juan III, Rey, 181

Juarez y Figueroa, Lorenzo, 182

Jung, Joachim, 226

Kebler, Lyman F., 341
Keill, James, 116
Keith, Arthur, 157, 159
Kelser, 32
Kilborne, 32, 39
King, Edmund, 227
Kircher, 100

Klaproth, M. H., 331, 343
Klebs, Arnold, 203
Klebs, Edwin, 18, 25
Knorr, Christian, 236

INDEX OF NAMES

353

Koch, Robert, 19, 26, 32, 33, 35-37, 39,
100

Kolisch, 165, 169
Kolle, 35

Korotkov, Nikolai S., 156, 160
Krenger, 132
Krogh, August, 158

Krumbhaar, E. B., 14, 35, 37, 103-129
Kubilai Khan, 247-249
Kuelz, 162, 164

Kussmaul, Adolf, 155, 160, 168
Kuyuk Khan, 249

I^caze, 311
Lactantius, 77

Lamnec, Rene T. H., 52, 154, 159, 160
I^argue, 26

Lifuente, D. Tadeo, 260
Lagrange, Joseph-Louis, 211
I^amarck, J. B., 213
Lambertenghi, Count Luigi, 286
Lamennais, 28

Lancisi, Giovanni Maria, 48-54, 100
Landcrgren, 166
Landois, Leonard, 155, 159
Langley, Thomas, 69, 74
Laplace, Pierre-Simon, 210
Lastres, Juan B., 130-151
Latini, Brunetto, 239
Laubry, Charles, 158, 160
Lavit, 309

Lavoisier, Antoine-Laurent, 209, 212

Lavoreria, Daniel E., 146, ISO

Lawrence, Effingham, 346

Lazzaretti, G., 64

Lea, Henry Charles, 297, 301

Ledru-Rollin, 18

Leeuwenhoek, Antonj van, 154

Legallois, J. J, C., 23

Lehmann-Nitsche, 136

Lely, G., 80

Lemery, 343

Leneus, Pompeius, 77

Leo X, Pope, 79

Leoniceno, Nicolo, 14

Leopardi, Giacomo, 14

Levasseur, 26

Leverrier, 211

Levialdi, Andrea, 214

Levine, Samuel, 159, 160

Levy-Briihl, 18

Lewis, Thomas, 157, 160
Leyden, Ernst von, 18
L’Hermite, 19
Libavius, Andreas, 227, 230
Libman, Emanuel, 157, 160
Liddle, Duncan, ^3
Lilly, Eli, 339, 340
Lily, 79

Limousin, Stanislas, 330, 331
Linacre, Thomas, 65, 79
Lind, James, 125
Lister, Joseph, 17
Littre, fimile, 18, 26
Livius, Marcus, 74
Loayza, Fray Geronimo de, 181
Lobacevskij, N. L, 212
Locke, John, 56, 58, 61
Loeb, J., 17
Loewi, Otto, 158, 159
Lombroso, Cesare, 62-64
Lopez, Pedro, 181, 182
Lopez, Velez, 136
Lordat, 310, 311, 316
Lorenzana de Marques, 182
Louis XII, King of France, 90
Lower, Richard, 227-230, 233
Luciani, Luigfi, 155-160
Lucrece, 100

Ludwig, Carl F., 155, 159
Lugol, 40

Luisada, Aldo A., 152-160
Lutembacher, Rene, 158
Luther, Martin, 191
Lyautey, Marshall, 31
Lyell, Charles, 213

McDaniel, W. B., 2d, 103-129

Macedo, Morales, 145

Mach, 18

Machi, 140

Machiavelli, 292

Mackenzie, James, 156, 157, 160

Magnus-Levy, Adolf, 161-169

Maimonides, Moses, 13, 203

Maissiat, 26 ,

Major, Joh. Daniel, 228
Maldonado, A., 138
Malesherbes, Lamoignon de, 293
Malpighi, Marcello, 11, 154, 212
Manet, 18, 23

Manfredi, Geronimo di, 203

354

INDEX OF NAMES

Manfrcdi, Signori of Faenza, 10
Mangy Khan, 243, 244
Manninger, R., 33
Manson, Sir P., 39
Manutius, Aldus, 65
Manzoni, Alessandro, 289, 303
Manzoni, Pietro, 289
Marat, J. P., 26
Marconi, 64
Marek, I., 33

Marey, Etienne J., 156, 160
Maria Theresa, 2^, 302
Maria, Visconti da Rho, 283
Markham, C., 144
Marroquin, Francisco, 181
Marsh, 166, 169
Marshall, Charles, 337
Martinez Duran, Carlos, 170-183
Martinotti, Giovanni, 11, 36
Maitland, 52
Marx, Karl, 17
Mary, Queen of England, 81
Masaryk, 29

Mathaeus Sylvaticus, 203
Matto, David, 131
Mautner, Hans, 158, 159
Maxwell, William, 224
May, Charles, 337
May, John, 337
Mayer, Claudius F., 184-204
Mayer, Michael, 224
Mayer, Robert, 210
Mayeme, 233

Mayow, John, 229, 230, 234

Meibom, H., 228

Menchaca, Francisco J., 215

Mendel, Gregor, 17

Menuret, 100

Mercado, Luiz de, 132

Mercatus, 126

Merck, Georg Franz, 331

Merck, Heinrich Emanuel, 331-333

Mering, G. von, 168

Merrell, Wm. S., 338

Merula, Gaudenzio, 186-188

Mesmer, F. A., 224

Mesue, 203

Metzger, G. Balth., 226
Meusnier, 37
Meyer, M. P., 318
Michelangelo, 315

Michell, John, 224
Middleton, John, 106
Mieli, Aldo, 205-216
Mignoto, Giammaria, 184-204
Mignotus, Johannes Maria (see Mig-*
noto)

Miller, Genevieve, 217-222
Minderer, Raimund, 231, 234-5
Minkowski, Oscar, 168
Minot, G. R., 38
Moctezuma, Emperor, 180
Moenckeberg, Johann G., 158, 159
Molina, Crist6bal de la, 138, 139, 142.
145

Monardes, N., 132
Monet, Jean-Baptiste, 213
Monge, C., 142
Monge, Gaspard, 211
Monro, Alexander Primus, 106
Monserrat, Montana de, 132
Montesquieu, 306
Montucla, Jean Etienne, 91
Moodie, Roy L., 145, 146, 148, 150
More, Thomas, 79

Morellet, Abb6 Andre, 283, 289, 292,
293, 299, 305, 306
Moreno, Fernando, 182
Morgagni, Giovanni Battista, 12, 13,
154, 159

Morgan, John, 13

Morgan, L. H., 17

Morquio, Luis, 156, 160

Morris, Anthony, 112

Morris, Benjamin, 103-129

Morris, Deborah, 114

Morson, Thomas N. R., 336, 337

Morton, R., 233

Moriia, 138, 142, 143, 145, 148

Mosso, A., 64

Mossolanus, 78

Moultrie, John, 106

Muller, Johannes, 212

Murphy, W. P., 38

Murri, Augusto, 12, 158, 160

Musa, Antonius, 76

Museus, 77

Musschenbrofck, 116

Mussolini, Benito, 38

Mynsicht, Hadrianus, 231

Mythriadates, King of Pontus, 78

INDEX OF NAMES

355

Nantas, Marie, 93
Napoleon III, 21, 22, 36
Naunyn, B., 18, 162-164, 169
Needham, 228, 230
Neisser, A., 19
Nestmann, 149

Neuburger, Max, 4, 11, 14, 223-236
Neumann, Caspar, 343
Neuschlosz, Simon M., 215
Newburg, 166, 169
Newton, Sir Isaac, 230
Noorden, Karl von, 164, 168-169
Noriega, Gutierrez, 149
Norodon, King of Cambodia, 26
Nunez del Arce, Manuel, 263

Obrastzow, W. P., 157

Oersted, H. C., 210

Ohm, Georg Simon, 210

Olano, 134, 139, 150

Oliver, William S., 155, 160

Olschki, Leonardo, 237-259

Ondegardo, Polo de, 142

Oosterdyk-Schacht, 116

Orias, Oscar, 159, 160

Orme, David, 103-129

Orozco, Manuel, 170

Osier, William, 156, 160

Ovando, Fray Nicolas de, 180

Owen, John, 224

Ozanam, Benoit, 90, 93

Ozanam, Charles, 92, 95

Ozanam, Elizabeth Baudin, 90

Ozanam, Frederic, 92

Ozanam, Jacques, 91, 92

Ozanam, Jean Antoine Franqois, 89-102

Pablo de Villamor, Fray Pedro, 182

Pachon, Michel-Victor, 157, 159

Pacinotti, 64

Padilla, Tiburcio, 158

Pagano, Guido, 156

Pagel, Walter, 100

Pal, Jakob, 156, 160

Pales, Leon, 147

Palma, R., 145

Paracelsus, 223-225, 332

Pardee, Harold E. B., 158, 160

Pare, Ambroise, 235

Parke, H. C., 340

Pasteur, Louis, 17-19, 26, 34-36, 39, 265,
331

Patin, Charles, 12

Paz, Fray Matias de, 181

Paz Soldan, Carlos Enrique, 260-266

Pegolotti, Francesco Balducci, 240. 258

Pelletier, Joseph, 330

Pena, Francisco de la, 132

Pensis, Cristoforo de, 66

Pepin, Roger, 318, 319, 324

Perriz, Cordova, Miguel Tadeo, 262-264

Peters, Mrs. John, 66

Petit, Marc-Antoine, 93

Petraeus, Heinrich, 236

Petren, 166, 169

Pettenkofer, Max, 17

Peyer, J. C., 228, 229

Pezzi, Cesare, 158, 160

Philip II, King of Spain, 172, 182

Philip, Master, 240

Piazzi, Giuseppe, 210

Pick, Ernst Peter, 158, 159

Pick, Friedel, 156

Pickett, 337

Pietschmann, 144

Pinel, P., 10

Pinero, Horacio, 45

Pintor, Pietro, 203

Pissaro, 18

Pius V, Pope, 177

Pizarro, F., 181

Pla, Cortes, 215

Plancy, J. A. S. Collin de, 306
Plato, 77

Platter, Felix, 233
Plenciz, M. A., 100
Pliny, 69, 76-78, 203, 239
Plummer, Andrew, 106
Poincare, H., 17
Pollender, A., 33
Polo, Marco, 237-259
Ponte, Gotardo da, 187, 190
Populus, 92
Porge, 167, 169
Posnansky, 146

Potain, Pierre C. E., 37, 155, 156, 160
Preciato, Gabriele, 203
Pringle, Sir John, 125
Proskauer, Curt, 267-282
Puccinotti, F., 4
Punderson, 342

Purman, Mathaeus Gottfried, 228, 235
Puteus, 14
Pythagoras, 77, 78

356

INDEX OF NAMES

Quetelet A., 297
Quevedo, Sergio, 145
Quincke, Heinrich, 155
Quinonez Osorio, Alvaro de, 182
Quiroga, Marcial, 45
Quiroga, Vasco de, 180

Rab, Georg, 274
Rabelais, 13

Ramazzini, Bernardo, 10, 13
Ranke, L., 168
Rasori, Giovanni, 13, 100
Raspail, 18, 26
Rayer, P. F. O., 34
Raynaud, Maurice, 155
Reaumur, R. de, 100
Recht, Emile, 12

Recklinghausen, Hans v., 157, 160

Reed, Walter, 32, 39

Refflem, R., 275

Rein, Hermann, 159

Remondini, 305

Renan, 17

Renouard, 68

Resta, Ricardo, 206, 215

Ricci, Ennio, 187, 188

Richard, Emperor of Germany, 318

Ricketts, H. T., 32

Ridley, Robert, 79, 228, 231

Riedel, Johann Daniel, 331

Riolan, Jean, 227

Riva Agtiero, 132, 133, 141

Riva-Rocci, Scipione, 52, 156, 160

Riverius, L., 116, 117

Rivero, Rodriquez, 180

Rivinus, A., 228

Robb, George P., 159, 160

Robert, 311

Roberts, S. H., 31

Robespierre, M. M. I., 93

Robiquet, P. J., 332

Roederer, Pierre Louis, 305

Roentgen, Wilhelm K., 152, 156, 160

Roesler, Hugo, 159, 160

Roger, Henri, 155, 160

Rokitansky, Carl v., 155, 159

Rolhnk, Werner, 227, 234

Rollo, 161, 162, 169

Romera, Vera Angela, 215

Romero, Jose Luis, 215

Roosevelt, 32

Ross, Sir Ronald, 32, 38, 39
Rothberger, Carl J., 157, 159
Rousseau, Henri, 23, 293
Rubrius, Aruncius, 76
Rummelin, Johannes, 229
Rush, Benjamin, 260
Rutherford, John, 106
Ryff, W. H., 223

Sachs, Hans, 267-282
Sahli, Adolf, 157
Saillans, Jean de, 90
St. Clair, Andrew, 106
St. Didier, 91

.Saint-Hilaire, Etienne Geoflfroy, 213
Saint Louis, 318 ^

Saint Roch, 185, 202
St. Sebastian, 202
Saint Simon, 95
St. Thomas the Apostle, 252
Salguero, Obispo, 183
Salomon, 77, 230
Samatan, Marta, 215
Sanchez, Ant6n, 181
Santillan, Hernando de, 181
Santo Carlo, 302
Santorio, Santorio, 9, 12
Sarmiento de Gamboa, 137
Sarton, George, 206, 283-308
Saussure, Raymond de, 23, 309-317
Saussure, Theodore de, 212
Sauvages, Boissier de, 310, 311
Savory, John, 337
Scarpa, Antonio, 94
Schacher, P. J., 228
Scheele, C. W., 338
Scheiner, Christoph, 229
Scherf, David, 158, 159
Sobering, Ernst, 332
Schiff, 163

Schlegel, Paul Marquard, 227
Schleiden, Mathias Jakob, 212
Schleswig, Duke of, 326
Schmiedeberg, Otto, 156, 159
Schneider, Conrad Victor, 228
Schoenlein, Lucas, 36
Schopff, Philipp, 223
Schopper, Hartmann, 275, 276
Schottmueller, Hugo, 157
Schroder, Joh., 231
Schultes, Johann, 235

INDEX OF NAMES

357

.#r

Schwann, Theodor, 212
Scory, John, Bishop of Hereford, 81, 82
Scudamore, Rt. Hon. Viscoumtess,
Frances, 81, 82
Seegen, 162
Segato, Gerolamo, 13
Seitler, 338

Senac, Jean Baptiste de, 154, 159, 160
Senebier, 212
Scnnert, Daniel, 108, 233
Serapion, 203

Sergius, an Armenian monk, 243-245

Sertuemer, F., 330

Seurat, 18

Severinus, 126

Shakespeare, 79

Sharp, A. P., 116, 125, 128, 338
Shoei^er, Robert, 338
Sibilla, 78

Siciliano, Luigi, 156

Sigerist, Henry E., 1-7, 216, 266

Silva Carvalho, Augusto da, 318-324

Simon, Lord Digby, 82

Singer, Charles, 10

Sisley, 18

Skipton, 231

Sk(^, Joseph, 154, 159
Sladecek, Josef, 3(®

Smith, Adam, 284

Smith, Miles, Bishop of Gloucester, 81-
83

Smith, Robert, 106
Smith, Theob^d, 32, 39
Smuts, 29
Sobolev, Ivan, 308
Sommering, S. T., 231
Soldi, Giacomo, 203
Sonnenfels, Joseph v., 302
Spallanzani, Lazzaro, 11, 23, 212
Spencer, Herbert, 17, 213
Spielmann, 331
Spitzer, Adolf, 158, 160
Sprat, Bishop, 225
Squire, Peter, 337
Stahl, Georg Ernst, 234, 312
Starling, Ernest H., 157, 159
Steams, Frederick, 338
Steell, Graham, 156, 160
Stefani, Aristide, 155, 159
Steinberg, Israel, 159, 160
Stephanus, Robertas, 68

Sternberg, Maximilian, 157
Stevin, 2^

Stewart, John, 106
Stokes, William, 37, 155, 160
Stoll, Arthur, 159
Stormont, David, Viscount, 106
Straschesko, N. D., 157
Straub, Walter, 157, 159
Streeter, Edward C., 187
Strong, 342

Suffusius, Numerius, 78
Swift, Jonathan, 56

Sydenham, Thomas, 55-61, 89, 90, 96-99.
115, 122, 125, 233-235

Taine, H., 17

Tanaquilla, wife of Tarquinius Priscus,
77

Tatius, Marcus, 71
Tawara, Sunao, 157, 159
Taylor, F. R., 340
Tello, J., 149
Theresias, 78
Thiers, 21

Thomas, Antoine, 318
Thomas, Comte de Savoie, 318
Thompson, J. Westfall, 87
Thorp, 81, 82
Thysius, A., 80
Tigerstedt, Robert, 158, 159
Tolstoi, Leo, 17
Tomtnasini, Giacomo, 11, 12
Torrella, Gaspare, 203
Tossignano, Pietro da, 190, 203
Tours, Guillaume Michel de, 72
Traube, Ludwig, 155, 160
Trelat, U., 26

Trendelenburg, Friedrich, 156, 157, 160
Trogus, 78

Trommsdorff, Joh. Bartholomaeus, 330

Trommsdorff, Hermaim, 330, 331

Trousseau, Armand, 26, 45, 125, 155

Tullius, Servius, 77

Tulp, 115, 122

Tunstall, Cuthbert, 79

Turner, Peter, 223

Twort, F. W., 41

Tyson, Edward, 228

Unna, Paul, 334
Urbino, DuJte of, 66

•I

i -

358 INDEX OF NAMES

Urdang, George, 325-346

Welch, W. H., 32

Wellcome, Henry S., 341

Vaillant, 26

Wenckebach, Karel F., 156, 158-160

Valcarcel, 136

Wepfer, Joh. Jacob, 229-233

Valdizan, H., 131, 138

Wharton, Thomas, 228, 230

Valladolid, 132

Whipple, George H., 38

Valles, F. 132

White, Paul D., 152, 159, 160

Vallisnieri, A., 100

Whitney, Edward A., 79, 87

Valsalva, Antonio Maria, 10

Whytt, Robert, 106

van Gogh, Vincent, 18

Wiggers, Carl J., 158-160

van Royen, 116

William of Rubruck, 243-246

Vaquez, Henri, 157, 158, 160

Williams, Herbert, 148, 149

Varro, M. T., 78

Willis, Thomas, 125, 228-233

Varron, 100

Wilson, Frank N., 159, 160

Vasquez, Pedro de, 180

Winslow, J. B., 116, 120 ^

Vaughan, Thomas, 225

Winter, Frederick, 116

Verdi, Giuseppe, 62

Wirdig, Sebastian, 225 j

Vergil, Polydore, 65-88

Wirsung, J. G., 228

Verri, Alessandro, 284, 286, 293, 294

Wiseman, Richard, 235 5

Verri, Carlo, 284

Withering, William, 154, 159

Verri, Conte Gabrielle, 284, 303

Witte, Friedrich, 332 ^

Verri, Pietro, 284, 286, 287, 293, 294,

Wohlfarth, G. Balth., 226 i

302, 303, 305

Wolf, Caspar Friedrich, 231 j

Vesalius, Andreas, 13, 14, 80, 154, 159

Wolfstri^el, Lorenz, 2^

Vesling, Johann, 229

Wolsey, Thomas, 79-81 <

Vespasianus, 77

Woodall, John, 223 i

Vieussens, Raymond, 154

Worringer, 136 j

Villari, Pasquale, 305

Wren, Christopher, 227

Vincent, Pascual, 306

Wuertz, Felix, 224

Viola, Sergie, 63

Wurtz, 21 f

Viracocha, 142

Wundt, W., 18

Virasoro, Rafael, 215

Wurfbain, J. P., 226

Virchow, Rudolph, 17, 29, 34, 155, 159

Wyeth, F. H., 340

Virgil, 94

Wyeth, John, 340

Volhard, Franz, 157

'■I

' 1

Volta, Alessandro, 64, 209

Xanthus, 76

Voltaire, 286, 287, 294, 303, 306

Waldeck-Rousseau, 27

Yazykov, Dimitri Ivanovich, 306 ,

Wallace, A. R., 213

Yoimg, Thomas, 210

Warner, Wm. R., 341

Wassermann, August, 35, 156

Zacutus, 126 -

Weber, 149

Zapata, Gollan Agustin, 215

Wecker, J. J., 223

Zeitler, 338

■

Wedel, Georg Wolfgang, 234

Ziemssen, Hugo, 162

Weintraud, 163, 164

Zinsser, Hans, 33

Weiss, Pedro, 148

Zola, Emile, 18

Weiss, Soma, 158, 160

Zoroastres, 77 1

k _

Weiss, Wm. E., 342, 343

Zumarraga, Obispo, 181

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